Overall Score
CMS Five-Star Quality Rating- Much below average
- Below average
- Average
- Above average
- Much above average
Where it ranks
- New HampshireAbove only 21% of peers73 rated homes · average 2.9★
- Hillsborough CountyAbove only 20% of peers21 rated homes · average 3.0★
- United StatesAbove only 20% of peers14,574 rated homes · average 3.0★
How the rating is built
- Health inspectionsStarting point1★−1.8 vs NH avg
- StaffingCan add or remove a star3★+0.1 vs NH avg
- Quality measuresCan add or remove a star5★+1.9 vs NH avg
CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.
Ratings & measures
Tap a row to see what it meansHealth inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersNH avg2.8★U.S. avg2.8★
Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.
It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.
Staffing ratingCMS stars from payroll-reported hours and turnover3★Above only 40% of peersNH avg2.9★U.S. avg2.9★
Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.
More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.
Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 89% of peersNH avg3.1★U.S. avg3.6★
Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.
It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.
Total nurse hoursPer resident per day, all nursing staff3.61hrsAbove 54% of peersNH avg3.89Benchmark4.10
All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.
Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.
RN hoursPer resident per day, registered nurses only1.20hrsTop 4%NH avg0.75Benchmark0.75
Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.
RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.
Nursing staff turnoverShare of nursing staff who left within a year · lower is better41%Above 70% of peersNH avg49%RN turnover35%
The share of nursing staff who left within the past year, from the same payroll data.
High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.
Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$12,735Above only 23% of peersNH avg$9,874Fines · denials1 · 0
Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.
Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.
Inspection history
Last three inspection cyclesCitations by monthMar 2023 – Dec 2025
- No actual harm (D–F)
- Actual harm (G–I)
- Immediate jeopardy (J–L)
- $Fine or payment denial
Showing
Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.
Dec 17, 2025Cycle 1worst G · actual harm$12,735
- F635Provide doctor's orders for the resident's immediate care at the time the resident was admitted.Resident Assessment and Care PlanningG · isolatedCorrected Nov 14, 2025
- F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Feb 9, 2026
Mar 13, 2025Cycle 1worst D · no actual harm
- F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsB · patternCorrected Apr 15, 2025
- F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Apr 22, 2025
- F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Apr 22, 2025
- F552Ensure that residents are fully informed and understand their health status, care and treatments.Resident RightsD · isolatedCorrected Apr 15, 2025
- F908Keep all essential equipment working safely.EnvironmentalD · isolatedCorrected Apr 22, 2025
Apr 2, 2024Cycle 2worst D · no actual harm
- Provide appropriate treatment and care according to orders, residentâs preferences and goals.Quality of Life and CareD · isolatedCorrected Apr 29, 2024
- F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareB · patternCorrected Apr 29, 2024
- F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceD · isolatedCorrected Apr 24, 2024
- F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Apr 19, 2024
Jan 9, 2024Cycle 3worst B · minimal potential harm
- F732Post nurse staffing information every day.Nursing and Physician ServicesB · patternCorrected Feb 2, 2024
May 4, 2023Cycle 3worst D · no actual harm
- F559Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.Resident RightsD · isolatedCorrected May 31, 2023
- F560Protect a residents' right to refuse some types of non-requested transfers within the nursing home.Resident RightsD · isolatedCorrected May 31, 2023
Mar 10, 2023Cycle 3worst D · no actual harm
- F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsD · isolatedCorrected Apr 7, 2023
Staffing
From quarterly payroll reportsHours per resident per day
- All nursing staffRNs, LPNs and aides combined3.61hrs
- Registered nursesRN hours only1.20hrs
- Licensed practical nursesLPN hours0.59hrs
- Nurse aidesCNA hours1.83hrs
- Weekend nursingAll staff on Saturdays and Sundays3.19hrs
- New Hampshire average
- Research benchmark (4.10 total, 0.75 RN)
Turnover & capacity
- Nursing staff turnoverShare who left within a year · lower is better41%Above 70% of peersNH avg 49%
- RN turnoverRegistered nurses only35%Not ranked by CMS
- Administrators who leftIn the past year1Leadership changed
- Occupancy70 certified beds · ~63 residents a day90%Above 70% of peersNH avg 82%
Fines & penalties
Roughly the past three yearsEnforcement summary
- $12,735In fines
- 1Fine
- 0Payment denials
- $9,874NH avg in fines
Actions on record
- Dec 17, 2025Civil money penalty$12,735
Ownership
As filed with CMSStructure
- Ownership type
- For profit - Corporation
- Chain
- Genesis Healthcare195 facilities in the chain2.4★ chain average
- Certification
- Medicare and Medicaid
- Location type
- Urban
- Ownership change
- None in the last 12 months
People and entities on file
- 191 Hackett Hill Road Operations LLC
- Fc-Gen Operations Investment LLC
- Gen Operations I LLC
- Gen Operations II LLC
- Genesis Healthcare INC
- Genesis Healthcare LLC
- Genesis Holdings LLC
- Genesis Nh Holdings LLC
- Genesis Operations LLC
- +8 more
- Elizabeth Cullerot
- Ayobami Ojutalayo
- Michael Berg
- Laura Bridgeford
- Avi Mendelson
Person Organization
Sources & notes
Public data, updated quarterlyData sources
- CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
- CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
- CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.
Notes
- CMS Certification Number 305038 · 191 HACKETT HILL ROAD, MANCHESTER, NH, 03102.
- Percentiles compare this facility with every rated nursing home in New Hampshire and Hillsborough County. Turnover and fines are inverted so a high percentile is always good.
- This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.









