Map showing the location of THE ELMS CENTER in MILFORD, New Hampshire
71 ELM STREET, MILFORD, NH, 03055

Overall Score

CMS Five-Star Quality Rating
1/5Much below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • New HampshireLowest tier among peers73 rated homes · average 2.9★
  • Hillsborough CountyLowest tier among peers21 rated homes · average 3.0★
  • United StatesLowest tier among 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 star1★−1.9 vs NH avg
  • Quality measuresCan add or remove a star2★−1.1 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 means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersNH avg2.8★U.S. avg2.8★
What is health inspection rating?

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.

Why it matters

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 turnover1★Lowest tier among peersNH avg2.9★U.S. avg2.9★
What is staffing rating?

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.

Why it matters

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 assessments2★Above only 11% of peersNH avg3.1★U.S. avg3.6★
What is quality measures rating?

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.

Why it matters

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 staff3.00hrsAbove only 3% of peersNH avg3.89Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

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 only0.64hrsAbove only 35% of peersNH avg0.75Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

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 better58%Above only 25% of peersNH avg49%RN turnover88%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

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$9,770Above only 26% of peersNH avg$9,874Fines · denials1 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
21citations
3inspection dates
1actual harm (G–I)
0immediate jeopardy (J–L)
Jan 10, 2025most recent

Citations by monthJan 2023 – Jan 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Jan 10, 202510 citationsCycle 1worst F · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Feb 7, 2025
  2. F552Ensure that residents are fully informed and understand their health status, care and treatments.Resident RightsD · isolatedCorrected Feb 7, 2025
  3. F578Honor 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.Resident RightsD · isolatedCorrected Feb 7, 2025
  4. F637Assess the resident when there is a significant change in conditionResident Assessment and Care PlanningB · patternCorrected Feb 2, 2025
  5. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Feb 21, 2025
  6. F732Post nurse staffing information every day.Nursing and Physician ServicesC · widespreadCorrected Feb 7, 2025
  7. 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 Feb 25, 2025
  8. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryD · isolatedCorrected Jan 27, 2025
  9. F838Conduct 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.AdministrationC · widespreadCorrected Jan 30, 2025
  10. F868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyAdministrationD · isolatedCorrected Feb 6, 2025
Jan 25, 20247 citationsCycle 2worst G · actual harm$9,770
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Feb 22, 2024
  2. F553Allow resident to participate in the development and implementation of his or her person-centered plan of care.Resident RightsC · widespreadCorrected Mar 1, 2024
  3. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Feb 26, 2024
  4. F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.Nursing and Physician ServicesF · widespreadCorrected Mar 1, 2024
  5. 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 Feb 23, 2024
  6. F811Ensure 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.Nutrition and DietaryD · isolatedCorrected Feb 23, 2024
  7. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Feb 22, 2024
Jan 20, 20234 citationsCycle 3worst D · no actual harm
  1. F885Report COVID19 data to residents and families.Infection ControlC · widespreadCorrected Jan 31, 2023
  2. F645PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care PlanningD · isolatedCorrected Feb 10, 2023
  3. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Feb 13, 2023
  4. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Feb 10, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.00hrsAbove only 3% of peers−0.89 vs NH avg
  • Registered nursesRN hours only0.64hrsAbove only 35% of peers−0.11 vs NH avg
  • Licensed practical nursesLPN hours0.67hrs
  • Nurse aidesCNA hours1.68hrs
  • Weekend nursingAll staff on Saturdays and Sundays2.38hrs
  • New Hampshire average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better58%Above only 25% of peersNH avg 49%
  • RN turnoverRegistered nurses only88%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy52 certified beds · ~47 residents a day90%Above 73% of peersNH avg 82%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $9,770In fines
  • 1Fine
  • 0Payment denials
  • $9,874NH avg in fines
Above only 26% of peersFewer fines than 26% of rated homes in New Hampshire

Actions on record

  1. Jan 25, 2024Civil money penalty$9,770

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
603 Healthcare7 facilities in the chain2.0★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Pr Nh Holdings LLC
  • Rr Nh Holdings LLC
  • Sean Stevenson
Indirect owners (5%+)
  • Philip Rausman
  • Robert Rausman
Operational or managerial control
  • 603 Healthcare LLC
  • Crystal Manchin
  • Ayobami Ojutalayo
  • Sean Stevenson

Person Organization

Sources & notes

Public data, updated quarterly

Data 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 305068 · 71 ELM STREET, MILFORD, NH, 03055.
  • 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.

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