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D
Poor

THE ELMS CENTER

71 ELM STREET · MILFORD, NH 03055

6036732907 · For profit - Limited Liability company

52 beds46.7 residents71 staff
CMS Five-Star Ratings
Overall
★★★★★
Staffing
★★★★★
Quality
★★★★★
Inspections
★★★★★
Staffing Grades
D
Poor
Total Staff
B
Good
RN Staff
D
Poor
Overall
✗CMS Benchmark(≥ 3.48 HPRD)
✗RN Recommendation(≥ 0.75 HPRD)
✗Research Standard(≥ 4.10 HPRD)
📋

What This Means in Plain English

THE ELMS CENTER receives an overall staffing grade of D (Poor). With 2.9988 total nurse hours per resident per day, this facility falls below the CMS staffing benchmark of 3.48 HPRD and has RN staffing of 0.6443 HPRD, below the recommended 0.75. It is 0.90 HPRD below the national average.

Weekend staffing drops significantly — dropping 26.72% compared to weekdays. The facility has low agency staff usage (3.66% of hours), suggesting a mostly permanent workforce.

Staffing levels have been declining over recent quarters — worth monitoring.

🔍 Areas of Concern (3)

🚨Does not meet the CMS staffing benchmark of 3.48 HPRD. Current: 2.9988 HPRD — needs 0.48 more hours per resident per day.
⚠️RN staffing (0.6443 HPRD) is below the research-recommended minimum of 0.75 HPRD. This means less clinical oversight per resident.
⚠️Weekend staffing drops 26.72% — significantly higher than average. Residents receive substantially less care on Saturdays and Sundays.

✨ Strengths (2)

✅No days with zero registered nurse hours this quarter
✅Low agency staff usage (3.66%) — mostly permanent, familiar staff
Total Nurse HPRD
2.9988hrs/resident/day▼ 0.90
CMS benchmark: 3.48
RN HPRD
0.6443hrs/resident/day▼ 0.04
Recommended: 0.75
Weekend Drop-off
26.72%
3.2438 weekday → 2.3771 weekend
⚠ Significant weekend reduction
Agency Staff
3.66%
8.91% of RN hours from contractors
Days with Zero RN
0days this quarter
4+ days = auto 1-star
CNA HPRD
1.0457hrs/resident/day
Direct care aides
LPN HPRD
0.6761hrs/resident/day
Licensed practical nurses
Consistency
0.4875std dev
Lower = more predictable

HPRD Over Time

Total nurse staffing hours per resident per day, by quarter

Total HPRD (shaded area)RN HPRDCMS Benchmark (3.48) — staffing standardResearch Standard (4.10) — recommended level

How Does This Facility Compare?

Compared to county, state, and national averages for total nurse HPRD

vs. Hillsborough County Average-0.74 HPRD
3.74
03.00 HPRD
vs. New Hampshire State Average-0.96 HPRD
3.96
03.00 HPRD
vs. National Average-0.90 HPRD
3.90
03.00 HPRD
■ Colored bar = this facility · | Black line = average · Based on 2025Q3 data

Nearby Facilities

Compare with other nursing homes in the area

FacilityDistanceGradeTotal HPRDRN HPRDCMS Rating
THE ELMS CENTER ★
MILFORD · This facility
—
D
2.99880.6443★☆☆☆☆
CRESTWOOD CENTER
MILFORD
0.3 mi
C
3.15790.8218★★★★★
Courville at Nashua
NASHUA
11.3 mi
C
3.70470.4318★★★★☆
Southern New Hampshire Rehabilitation & Healthcare
NASHUA
11.7 mi
D
2.98870.709★☆☆☆☆
BEDFORD NURSING & REHABILITATION CENTER
BEDFORD
12.2 mi
C
3.19050.529★★☆☆☆
RIDGEWOOD CENTER, GENESIS HEALTHCARE
BEDFORD
12.4 mi
C
3.2041.0729★★☆☆☆

Inspection History & Penalties

Health inspection results from state surveys — most recent first

3
Inspections
21
Total Deficiencies
$9,770
Fines Assessed
Jan 10, 2025Health
10 deficiencies cited
▼
Jan 25, 2024Health
7 deficiencies cited· Includes actual harm
▼
Jan 20, 2023Health
4 deficiencies cited
▼

Penalty History

Jan 25, 2024Fine
$9,770
CMS Severity Scale
A–C: No Harm / PotentialD–F: No Harm but ConcernG–H: Actual HarmI–L: Immediate Jeopardy

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.