Madigan Estates
93 Military Street, Houlton, ME 04730 · Aroostook County · (207) 532-6593
99 certified beds, about 97 residents a day · For profit - Corporation · Medicare and Medicaid since 1993
Certified for Medicaid Certified for Medicare
Overall
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 205083 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 22, 2025, inspectors cited 12 health deficiencies (the Maine average is 10.8, the national average 9.2).
Of 26 health citations since May 2023, 1 was rated as actual harm or immediate jeopardy to residents.
CMS lists 1 fine totaling $11,450 in the last three years; the largest was $11,450, and the latest is dated November 14, 2023.
Nurses and nurse aides worked 3.95 hours per resident per day, against 4.34 across Maine and 3.86 nationally. Registered nurses accounted for 0.85 of those hours.
42.6% of nursing staff left within the year CMS measured (Maine average 46.7%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
405/23
211/23
603/24
101/25
1205/25
107/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 26 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
1G
0H
0I
Potential for more than minimal harm
16D
7E
0F
Potential for minimal harm
0A
1B
1C
July 30, 2026Complaint inspection · 1 citation
- E Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record reviews and interviews, the facility failed to follow physician orders or enter treatment orders for wounds when found for 5 of 20 residents reviewed (Resident #9 [R9], R62, R63, R39, and R98).
May 22, 2025Standard inspection, Complaint inspection · 12 citations
- D Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Inspectors wroteBased on record review and interview, the facility failed to ensure an as needed (prn) psychotropic medication met the required 14-day limit for 1 of 5 Resident's reviewed for unnecessary medications (Resident #5 [R5]).
- D Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on facility policy review and interviews, the facility failed to ensure an alleged allegation of physical and verbal abuse was reported to the Division of Licensing and Certification for 1 of 2 residents reviewed (Resident #13 [R13]).
- D Respond appropriately to all alleged violations.
Inspectors wroteBased on facility policy review, record review, and interview, the facility failed to ensure an allegation of physical and verbal abuse was investigated for 1 of 2 complaints reviewed (Resident #13 [R13]).
- D Ensure each resident receives an accurate assessment.
Inspectors wroteBased on record reviews and interview, the facility failed to ensure that the Minimum Data Set (MDS) 3.0 was coded accurately on a Significant Change MDS assessment to indicate that a resident had a State Level II Preadmission Screening and Resident Review (PASRR) for 1 of 3 residents reviewed for PASRR (Resident #60 [R60]).
- D Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Inspectors wroteBased on clinical record review and interview, the facility failed to ensure a baseline care plan was developed and implemented within 48 hours, that included the instructions needed to provide minimum healthcare information necessary to properly care for 1 of 5 newly admitted residents (Resident #26 [R26]).
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on record reviews and interview, the facility failed to revise a care plan after a resident qualfied for Preadmission Screening and Resident Review (PASRR) Level II services for 1 of 3 residents reviewed for PASRR (Resident #60 [R60]).
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on record reviews, policy review, and interviews, the facility failed to follow a policy for completing neurological assessments after a fall for 1 of 2 sampled residents who had fallen and hit their head (Resident #66 [R66]).
- D Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on record reviews and interview, the facility failed to ensure the physician orders included an order for the use of a Foley catheter for 1 of 2 residents (Resident #26 [R26]).
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations and interviews, the facility failed to ensure that dented cans were removed from use, the facility failed to ensure products in the reach-in refrigerator located in the kitchens back room were labeled, in addition the facility failed to ensure all kitchen staff were wearing facial hair restraints on 1 of 4 days of survey (5/19/25)
- D Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on record reviews and interview, the facility failed to ensure that a resident's record contained the Power of Attorney paperwork for 1 of 6 residents reviewed for Advance Directives (Resident #60 [R60]).
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and record review the facility failed to maintain an Infection Control Program designed to help prevent the development and spread of infection related to Enhanced Barrier Precautions (EBP) for 1 of 2 sampled residents reviewed on EBP (Resident #42 [R42]).
- D Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Inspectors wroteBased on Certified Nursing Assistant (CNA) employee education record review and interview, the facility failed to implement and maintain an effective training program to ensure that a CNA attended the required 12 hours of annual in-service education training, and annual dementia training for 1 of 4 randomly selected CNAs reviewed on survey (CNA #1 [CNA1]).
January 22, 2025Complaint inspection · 1 citation
- D Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Inspectors wroteBased on record reviews, and interviews, the facility failed to ensure a resident was free from abuse for 1 of 1 residents reviewed for abuse (Resident #1 [R1]).
March 21, 2024Standard inspection · 6 citations
- E Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on interviews, record review, and observation, the facility failed to ensure that a physician order for a mechanical soft diet was followed for 1 of 3 residents reviewed for nutrition (Resident #5 [R5]).
- E Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observations and interviews the facility failed to ensure respiratory care equipment was hooked up properly for 1 of 1 resident reviewed for respiratory care (Resident #143 [R143])
- E Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Inspectors wroteBased on observations and interviews, the facility failed to ensure expired medications and topicals were removed from the supply available for use in 2 of 2 treatment carts (#1 and #2), 1 of 1 medication carts (#2) and 2 of 2 medication storage rooms (#1 and #2) reviewed. In addition, the facility failed monitor temperatures in a medication refrigerator that insulin was stored in for 1 of 2 medication storage rooms (#1).
- E Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on record reviews and interview, the facility failed to ensure that clinical records were complete and contained accurate information for 2 of 20 residents reviewed for catheter use and for medication and treatment administration (Resident #144 and #83 [R144, R83]).
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on record review and interview, the facility failed to ensure that the State Mental Health authority for Pre-admission Screening and Resident Review (PASRR) was notified of a newly added mental health disorder diagnosis to determine from a PASRR Level I screen if a change in level of service is required for 1 of 3 sampled residents reviewed for PASRR (Resident #74 [R74]).
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations and interview facility failed to enure that food products were dated and labeled, and failed to ensure dented cans were taken out of circulation for use on 2 of 4 days of survey (3/18/24; 3/21/24).
November 14, 2023Complaint inspection · 2 citations
- G Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on facility reported incident review, facility investigation, record review, and interviews, the facility failed to ensure that a resident received the proper level of assistance during a transfer when a Certified Nursing Assistant (CNA) did not review how the resident transferred and used a single assist bear hug method, when the resident was a two person Hoyer Mechanical Lift for 1 of 1 incidents received (10/26/23). The failure to transfer the resident via Hoyer Lift resulted in Resident #2 [R2] requiring transfer to an acute care hospital, sustaining a non-displaced fracture proximal to the right tibia, experiencing pain and anxiety after the injury occurred. On 11/14/23, the facility reported incident (FRI) and facility investigation sent to the Division of Licensing and Certification (State Agency) were reviewed. [...]
- B Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on facility policy review, the facility reportable incident report, investigation review, employee timecard review, and interview, the facility failed to protect residents from further abuse by allowing the alleged perpetrator to work 2 of 2 scheduled shifts (7/4/23 and 7/5/23), prior to investigation completion.
May 24, 2023Standard inspection · 4 citations
- E Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure that physician orders were followed for 1 of 3 residents observed during a medication pass (Resident #4).
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations and interviews, the facility failed to ensure foods in the freezer remained frozen solid for 1 of 1 observation and with review of the walk-in freezer temperature log sheets for the past 6 months. (5/22/23)
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation and interview, the facility failed to ensure that staff washed/sanitized their hands during a medication pass observation for 1 of 3 medication pass observations.
- C Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on review of the facility's 'Influenza Immunization Policy,' admission Influenza Consent form and interview, the facility failed to provide the Resident and/or the Resident's Representative with the Vaccine Information Statement (VIS)' prior to immunizing a resident with the influenza vaccine for all residents receiving the influenza vaccine who are not new admissions.
Fire safety inspections
13 fire safety citations on file: 9 on May 22, 2025, 4 on May 24, 2023.
Every fire safety citation13 citations
- D Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D Have properly located and lighted "Exit" signs.
- D Install an approved automatic sprinkler system.
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- D To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- D Meet requirements for the installation and maintenance of electrical systems.
- D Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- D Ensure proper usage of power strips and extension cords.
- D Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D Have exits that are accessible at all times.
- D Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D Ensure proper usage of power strips and extension cords.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| November 14, 2023 | Fine | $11,450 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Maine | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.95 | 4.34 | 3.86 |
| Registered nurses | 0.85 | 1.05 | 0.69 |
| All nursing staff on weekends | 3.64 | 3.92 | 3.42 |
| Nurse aides | 2.60 | ||
| Licensed practical nurses | 0.50 | ||
| Nursing staff turnover (share who left in a year) | 42.6% | 46.7% | 45.8% |
| Registered nurse turnover | 23.8% | 40.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.64 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.08 on weekdays and 3.64 on weekends, 11% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.9% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.28 in April to June 2025 to 3.95 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.95 | 0.85 | 4.08 | 3.64 | 0.9% | 0 of 90 | 97 |
| Oct to Dec 2025 | 4.06 | 0.86 | 4.25 | 3.57 | 1.1% | 0 of 92 | 95 |
| Jul to Sep 2025 | 4.43 | 0.89 | 4.71 | 3.72 | 0.9% | 0 of 92 | 94 |
| Apr to Jun 2025 | 4.28 | 0.89 | 4.57 | 3.56 | 1.0% | 0 of 91 | 92 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Maine, Jan to Mar 2026 | 4.35 | 1.06 | 4.52 | 3.95 | 9.2% | 0.2% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Maine | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 30.0 | 24.4 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 2.3 | 1.1 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 3.8 | 2.2 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 7.1 | 4.1 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.2 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 26.5 | 25.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.4 | 4.3 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 23.9 | 20.2 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 13.3 | 20.8 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 19.1 | 16.1 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.0 | 1.4 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.3 | 2.0 | 1.8 |
Owners and operators
Legal business name: MAPLE GROVE NURSING HOME, INC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Brown, James | 5% or greater direct ownership interest | Individual | 100% | 12/31/2021 |
| Brown, James | Indirect ownership interest | Individual | 12/31/2021 | |
| Brown, James | Corporate director | Individual | 07/01/1996 | |
| Abouleish, Hassan | Operational/managerial control | Individual | 01/01/2015 | |
| Brown, Dana | Operational/managerial control | Individual | 12/01/2024 | |
| Brown, James | Operational/managerial control | Individual | 07/01/1996 | |
| Russell, Ashley | Operational/managerial control | Individual | 01/01/2020 | |
| Brown, James | Trustee of the SNF | Individual | 12/31/2021 | |
| Abouleish, Hassan | Adp of the SNF | Individual | 01/01/2015 | |
| Brown, Dana | Adp of the SNF | Individual | 12/01/2024 | |
| Brown, James | Adp of the SNF | Individual | 12/31/2021 | |
| Russell, Ashley | Adp of the SNF | Individual | 01/01/2020 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 7 problems in this area, most recently on July 30, 2026: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- When is the care plan meeting, and can family attend it?Inspectors cited 6 problems in this area, most recently on May 22, 2025: "Ensure each resident receives an accurate assessment."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 5 problems in this area, most recently on May 22, 2025: "Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 3 problems in this area, most recently on May 22, 2025: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.64 hours per resident per day, below the Maine average of 3.92.
Maine contacts for a concern about a nursing home
These are the official offices in Maine. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Maine DHHS Division of Licensing and Certification, Nursing Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Maine Long-Term Care Ombudsman Program, (800) 499-0229. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Maine DLC Licensed Provider Search, where Maine publishes its own records on licensed homes.
Common questions
- What is Madigan Estates's Medicare star rating?
- CMS rates Madigan Estates 3 out of 5 stars overall, with 3 for health inspections, 4 for staffing and 2 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Madigan Estates get at its last inspection?
- 12 health deficiencies at the standard inspection on May 22, 2025. The Maine average is 10.8.
- Has Madigan Estates been fined?
- Yes. CMS lists 1 fine totaling $11,450 in the last three years.
- Does Madigan Estates accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Madigan Estates?
- CMS lists 12 owners and managers. Legal business name: MAPLE GROVE NURSING HOME, INC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.