Home / New Hampshire / Milford
The Elms Center
71 Elm Street, Milford, NH 03055 · Hillsborough County · (603) 673-2907
52 certified beds, about 44 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1996
Certified for Medicaid Certified for Medicare
Overall
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 305068 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on February 24, 2026, inspectors cited 1 health deficiency (the New Hampshire average is 4, the national average 9.2).
Of 19 health citations since January 2024, 1 was rated as actual harm or immediate jeopardy to residents.
CMS lists 1 fine totaling $9,770 in the last three years; the largest was $9,770, and the latest is dated January 25, 2024.
Nurses and nurse aides worked 3.02 hours per resident per day, against 3.90 across New Hampshire and 3.86 nationally. Registered nurses accounted for 0.74 of those hours.
64.0% of nursing staff left within the year CMS measured (New Hampshire average 44.1%).
CMS links it to 603 Healthcare, an affiliated group of 7 nursing homes.
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.
701/24
1001/25
102/26
105/26
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 19 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
1G
0H
0I
Potential for more than minimal harm
12D
0E
2F
Potential for minimal harm
0A
1B
3C
May 27, 2026Complaint inspection · 1 citation
- D Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
Inspectors wroteBased on interview and record review, the facility failed to ensure physician orders at admission were accurate for 1 of 4 residents reviewed for admission orders (Resident identifier is #4).
February 24, 2026Standard inspection · 1 citation
- D Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspectors wroteBased on interview, and record review, the facility failed to provide routine medications to meet the needs of the residents for 1 of 1 resident reviewed for dialysis and 1 of 1 resident reviewed for choices. (Resident identifiers are #3 and #49.)
January 10, 2025Standard inspection · 10 citations
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on interview and record review, it was determined that the facility failed to implement and review, at least annually, the facility's water management plan that has the potential to effect the facility census of 46 residents who resided at the facility.
- D Ensure that residents are fully informed and understand their health status, care and treatments.
Inspectors wroteBased on interview and record review, it was determined that the facility failed to ensure that a resident is fully informed of their care and treatment in a language that he/she understands for 1 of 2 residents reviewed for communication in a final sample of 16 residents. (Resident identifier is #44.)
- D Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Inspectors wroteBased on interview and medical record review, it was determined that the facility failed to ensure the resident's right to formulate advance directives for 1 out of 2 residents reviewed for advance directives (Resident Identifier is #35).
- 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 review and interview, it was determined that the facility failed to hold routine interdisciplinary care plan meetings for 2 of 16 residents reviewed for care planning in a final sample of 16 residents (Resident identifiers are #24 and #44).
- D 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 observation, interview, and record review, it was determined that the facility failed to ensure that multidose medications were labeled with opened/expiration dates appropriately in 1of 1 medication cart reviewed and expired medications were removed from use in 1 out of 1 medication room observed.
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interview and policy review, it was determined that the facility failed to ensure that food was labeled and failed to maintain a clean environment in the food preparation area for the main kitchen observed.
- D Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on interview and record review, it was determined that the facility failed to ensure that the required committee members attended Quality Assurance Performance Improvement (QAPI) meetings at least quarterly for 2 of the 4 quarterly meetings reviewed for 2024.
- C Post nurse staffing information every day.
Inspectors wroteBased on observation and interview, it was determined that the facility failed to post daily the nurse staffing information.
- C Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Inspectors wroteBased on record review and interview, it was determined that the facility failed to ensure that the facility assessment included specific staffing needs for each shift such as day, evening, and night.
- B Assess the resident when there is a significant change in condition
Inspectors wroteBased on record review and interview, it was determined that the facility failed to conduct a comprehensive Minimum Data Set (MDS) assessment within 14 days after a significant change was determined for 1 of 1 resident reviewed for hospice and 1 of 2 residents closed records reviewed in a final sample of 16 residents (Resident identifiers are #47 and #24).
January 25, 2024Standard inspection, Complaint inspection · 7 citations
- G Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to assess a resident after implementing a new device for safety resulting in a fall with serious injury for 1 out of 4 residents reviewed for accidents in a final sample of 20 residents (Resident Identifier is #26).
- F Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspectors wroteBased on interview, observation, and record review, it was determined that the facility failed to ensure sufficient staffing to ensure that each resident attained or maintained the highest practicable physical, mental, and psychosocial well-being. Facility census of 52 residents (Resident Identifier #153).
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow physician orders for 5 residents in a final sample of 20 residents (Resident Identifiers are #5, #21, #31, #40, and #47).
- D 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 observation, interview, and record review, it was determined that the facility failed to store medication and therapeutic nutrition according to manufacturer instructions in 1 of 1 medication carts observed and 1 of 1 resident reviewed from tube feeding in a final sample of 20 residents (Resident Identifier is #152).
- D Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.
Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to ensure that a resident with complicated feeding problems was not assisted by feeding assistants, failed to supervise paid feeding assistants during dining, and failed to select residents who could be fed by feeding assistants based on an interdisciplinary team's assessment for 1 of 1 residents observed being fed during a dining observation (Resident Identifier is #12).
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on record review, observation, interview, and policy review it was determined that the facility failed to follow Transmission Based Precautions (TBP) for 1 of 3 residents reviewed for infection control (Resident Identifier is #200).
- C Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Inspectors wroteBased on interview and record review, it was determined that the facility failed to notify the resident and/or resident's representative of care plan meetings for 1 resident in a final sample of 20 residents (Resident Identifier is #31).
Fire safety inspections
9 fire safety citations on file: 3 on February 24, 2026, 3 on January 10, 2025, 3 on January 25, 2024.
Every fire safety citation9 citations
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- D Have generator or other power source capable of supplying service within 10 seconds.
- B Install emergency lighting that can last at least 1 1/2 hours.
- F Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E Install emergency lighting that can last at least 1 1/2 hours.
- C Provide properly protected cooking facilities.
- E Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D Have generator or other power source capable of supplying service within 10 seconds.
- C Install emergency lighting that can last at least 1 1/2 hours.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| January 25, 2024 | Fine | $9,770 |
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 | New Hampshire | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.02 | 3.90 | 3.86 |
| Registered nurses | 0.74 | 0.78 | 0.69 |
| All nursing staff on weekends | 2.67 | 3.47 | 3.42 |
| Nurse aides | 1.66 | ||
| Licensed practical nurses | 0.62 | ||
| Nursing staff turnover (share who left in a year) | 64.0% | 44.1% | 45.8% |
| Registered nurse turnover | 77.8% | 40.9% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.92 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 3.17 on weekdays and 2.67 on weekends, 16% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 4.8% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.23 in April to June 2025 to 3.02 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 | 3.02 | 0.74 | 3.17 | 2.67 | 4.8% | 0 of 90 | 44 |
| Oct to Dec 2025 | 2.88 | 0.62 | 3.00 | 2.59 | 1.6% | 0 of 92 | 46 |
| Jul to Sep 2025 | 3.00 | 0.64 | 3.24 | 2.38 | 3.7% | 0 of 92 | 47 |
| Apr to Jun 2025 | 3.23 | 0.55 | 3.44 | 2.69 | 11.1% | 0 of 91 | 44 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| New Hampshire, Jan to Mar 2026 | 3.85 | 0.74 | 4.01 | 3.45 | 13.1% | 0.1% 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 | New Hampshire | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 30.6 | 22.7 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.0 | 1.1 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 2.0 | 2.1 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 4.9 | 4.4 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 29.9 | 17.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.3 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 18.0 | 17.8 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 38.7 | 22.3 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 7.8 | 13.4 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.7 | 1.6 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.7 | 1.9 | 1.8 |
Owners and operators
Legal business name: MILFORD SNF OPCO LLC. CMS links this home to 603 Healthcare, a group of 7 nursing homes averaging 3.6 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Pr Nh Holdings LLC | 5% or greater direct ownership interest | Organization | 48% | 02/19/2024 |
| Rr Nh Holdings LLC | 5% or greater direct ownership interest | Organization | 48% | 02/19/2024 |
| Stevenson, Sean | Direct ownership interest | Individual | 02/19/2024 | |
| Rausman, Philip | Indirect ownership interest | Individual | 09/01/2024 | |
| Rausman, Robert | Indirect ownership interest | Individual | 09/01/2024 | |
| 603 Healthcare LLC | Operational/managerial control | Organization | 09/01/2024 | |
| Manchin, Crystal | Operational/managerial control | Individual | 09/01/2024 | |
| Ojutalayo, Ayobami | Operational/managerial control | Individual | 09/01/2024 | |
| Stevenson, Sean | Operational/managerial control | Individual | 09/01/2024 | |
| 603 Healthcare LLC | Adp of the SNF | Organization | 01/29/2025 | |
| Manchin, Crystal | Adp of the SNF | Individual | 09/01/2024 | |
| Ojutalayo, Ayobami | Adp of the SNF | Individual | 09/01/2025 |
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.
- When is the care plan meeting, and can family attend it?Inspectors cited 4 problems in this area, most recently on May 27, 2026: "Provide doctor's orders for the resident's immediate care at the time the resident was admitted."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 3 problems in this area, most recently on February 24, 2026: "Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 3 problems in this area, most recently on January 10, 2025: "Ensure that residents are fully informed and understand their health status, care and treatments."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 2 problems in this area, most recently on January 10, 2025: "Provide and implement an infection prevention and control program."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.67 hours per resident per day, below the New Hampshire average of 3.47.
- How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.
Other nursing homes nearby
- Crestwood Center Milford, 0.3 mi · 4 of 5 stars · 13 citations
- Courville at Nashua Nashua, 11.3 mi · 5 of 5 stars · 10 citations
- Nashua Post Acute Care Nashua, 11.7 mi · 1 of 5 stars · 29 citations
- Bedford Nursing & Rehabilitation Center Bedford, 12.2 mi · 1 of 5 stars · 15 citations
- Ridgewood Center, Genesis Healthcare Bedford, 12.4 mi · 2 of 5 stars · 14 citations
- Bedford Hills Center Bedford, 12.5 mi · 4 of 5 stars · 8 citations
- Hillsborough County Nursing Home Goffstown, 13.5 mi · 5 of 5 stars · 9 citations
- Fairview Nursing Home Hudson, 13.8 mi · 1 of 5 stars · 16 citations
Common questions
- What is The Elms Center's Medicare star rating?
- CMS rates The Elms Center 2 out of 5 stars overall, with 3 for health inspections, 1 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did The Elms Center get at its last inspection?
- 1 health deficiency at the standard inspection on February 24, 2026. The New Hampshire average is 4.
- Has The Elms Center been fined?
- Yes. CMS lists 1 fine totaling $9,770 in the last three years.
- Does The Elms Center 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 The Elms Center?
- CMS lists 12 owners and managers, and links the home to 603 Healthcare. Legal business name: MILFORD SNF OPCO LLC.
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.
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