The Elms Center

71 Elm Street · Milford, NH · 03055 · 6036732907

52 certified beds For profit - Limited Liability company Chain: 603 Healthcare

  • Inspection results have improved across recent cycles.

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Red flags

Total nurse staffing below 3.0 hours per resident-day

2.88 reported hours vs the 3.48 minimum CMS's own staffing study recommends.

62% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 75
Serious harm & abuse 20% 94
Staffing 20% 53
Federal penalties 15% 76
Trend 10% 92
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 2 of 5 Inspections: 3 of 5 Staffing: 1 of 5 Quality measures: 3 of 5

Total nurse hours / resident-day2.883.48 min · 4.1 strong
RN hours / resident-day0.620.55–0.75
Weekend hours / resident-day2.59≈ weekday level
Nursing turnover / year62%median 45%
Fines (3-yr window)1 · $9,770

Inspection citations (18 in the current record)

  • Potential for harm · D February 24, 2026

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Corrected March 19, 2026 · Pharmacy Service

  • Potential for harm · D January 10, 2025

    Ensure that residents are fully informed and understand their health status, care and treatments.

    Corrected February 7, 2025 · Resident Rights

  • Potential for harm · D January 10, 2025

    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.

    Corrected February 7, 2025 · Resident Rights

  • Potential for harm · D January 10, 2025

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected February 21, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 10, 2025

    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.

    Corrected February 25, 2025 · Pharmacy Service

  • Potential for harm · D January 10, 2025

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected January 27, 2025 · Nutrition and Dietary

  • Potential for harm · D January 10, 2025

    Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

    Corrected February 6, 2025 · Administration

  • Potential for harm · F January 10, 2025

    Provide and implement an infection prevention and control program.

    Corrected February 7, 2025 · Infection Control

  • No harm found · B January 10, 2025

    Assess the resident when there is a significant change in condition

    Corrected February 2, 2025 · Resident Assessment and Care Planning

  • No harm found · C January 10, 2025

    Post nurse staffing information every day.

    Corrected February 7, 2025 · Nursing and Physician Services

  • No harm found · C January 10, 2025

    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.

    Corrected January 30, 2025 · Administration

  • Actual harm · G January 25, 2024 · found via complaint

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected February 22, 2024 · Quality of Life and Care

  • Potential for harm · D January 25, 2024

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected February 26, 2024 · Resident Assessment and Care Planning

  • Potential for harm · F January 25, 2024

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Corrected March 1, 2024 · Nursing and Physician Services

  • Potential for harm · D January 25, 2024

    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.

    Corrected February 23, 2024 · Pharmacy Service

  • Potential for harm · D January 25, 2024

    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.

    Corrected February 23, 2024 · Nutrition and Dietary

  • Potential for harm · D January 25, 2024

    Provide and implement an infection prevention and control program.

    Corrected February 22, 2024 · Infection Control

  • No harm found · C January 25, 2024

    Allow resident to participate in the development and implementation of his or her person-centered plan of care.

    Corrected March 1, 2024 · Resident Rights

Federal penalties

DateTypeAmount / length
January 25, 2024Fine$9,770

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 305068 · certified since August 1, 1996. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.