THE ELM'S NURSING AND REHAB CENTER
Address
71 ELM STREET
MILFORD, NH 03055
(603) 673-2907
Nursing Home Ratings
| Health Inspections | |
| Quality Measures | |
| Nursing Staff | |
| R.N. Staff Only | |
| Overall Rating | |
Percent of Beds Occupied
94%Number of Residents and Certified Beds
- Residents: 49
- Certified Beds: 52
This Facility Accepts
- Medicare
- Medicaid
Operational Details
- Operated By For Profit - Corporation
- Offers Only Resident Counseling
- This Facility is Part of a Chain or Franchise
Resident Services
The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "Ultra-High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by The Elm's Nursing and Rehab Center. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.
| Resident Services | Resident Conditions | Percent of Service Days |
Ultra-High Rehabilitation
- At least one rehabilitation discipline five days/week
- A second rehabilitation discipline three days/week
| ADL Index Range: 11-16 | 12.1% |
| ADL Index Range: 6-10 | 17.3% |
| ADL Index Range: 0-5 | 29.0% |
| Total Percent: | 58.5% |
Very High Rehabilitation
- At least one rehabilitation discipline five days/week
| ADL Index Range: 6-10 | 15.4% |
| ADL Index Range: 0-5 | 8.7% |
| Total Percent: | 24.0% |
High Rehabilitation
- At least one rehabilitation discipline five days/week
| ADL Index Range: 6-10 | 4.2% |
| Total Percent: | 4.2% |
Medium Rehabilitation
- Five days any combination of three rehabilitation disciplines
| ADL Index Range: 6-10 | 4.2% |
| ADL Index Range: 0-5 | 4.2% |
| Total Percent: | 8.5% |
Special Care Low
- Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
- Respiratory failure and oxygen therapy while a resident
- Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
- Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
- Ulcers: 2 or more venous or arterial ulcers
- Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
- Foot infection/diabetic foot ulcer/open lesions of foot with treatment
- Radiation therapy while a resident
- Dialysis while a resident
- Activities of Daily Living (ADL) score of 2 or more
| ADL Index Range: 11-14 - No Signs of depression | 1.2% |
| ADL Index Range: 6-10 - No Signs of depression | 3.5% |
| Total Percent: | 4.6% |
Clinically Complex
- Pneumonia, hemiplegia with ADL score >=5
- Surgical wounds or open lesions with treatment
- Burns
- Chemotherapy while a resident
- Oxygen therapy while a resident
- IV medications or transfusions while a resident
- Extensive Services, Special Care High or Special Care Low qualifier and ADL score of 0 or 1
| ADL Index Range: 0-1 - No Signs of depression | 0.2% |
| Total Percent: | 0.2% |
Rating Details For The Elm's Nursing and Rehab Center
Nursing Staff - 
The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.
| Nursing Hours Per Resident Per Day | Reported | Expected |
| Registered Nurse (RN) Hours | 55 Minutes | 1 Hour and 11 Minutes |
| Licensed Practical/Vocational Nurse (LPN/LVN) Hours | 27 Minutes | 42 Minutes |
| Certified Nursing Assistant (CNA) Hours | 1 Hour and 46 Minutes | 2 Hours and 22 Minutes |
| Total Licensed Nurse Hours | 1 Hour and 22 Minutes | 1 Hour and 53 Minutes |
| Total Nurse Hours | 3 Hours and 8 Minutes | 4 Hours and 15 Minutes |
Quality of Care - 
Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for New Hampshire are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.
| This Facility | New Hampshire Average |
Long-Term Stay Preventive Actions
| Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 90-100% | 94% |
| Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season | 90-100% | 94% |
Long-Term Stay Deficiencies
| Percent of Long-Stay Residents Who Were Physically Restrained | - | 4% |
| Percent of Long-Stay Residents Who Are More Depressed or Anxious | 21% | 18% |
| Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores | 2% | 3% |
| Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder | 9% | 6% |
| Percent of Long-Stay Residents Who Have Moderate to Severe Pain | 1% | 3% |
| Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased | 26% | 17% |
| Percent of Long-Stay Residents Who Had a Urinary Tract Infection | 6% | 8% |
| Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder | 44% | 51% |
| Percent of Long-Stay Residents Who Lose Too Much Weight | 4% | 7% |
| Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair | 1% | 4% |
| Percent of High-Risk Long-Stay Residents Who Have Pressure Sores | 18% | 8% |
| Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse | 15% | 15% |
Short-Term Stay Preventive Actions
| Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season | 83% | 90% |
| Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 87% | 90% |
Short-Term Stay Deficiencies
| Percent of Short-Stay Residents Who Have Delirium | - | 2% |
| Percent of Short-Stay Residents Who Have Pressure Sores | 12% | 11% |
| Percent of Short-Stay Residents Who Had Moderate to Severe Pain | 13% | 24% |
Health Inspection Details -
All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 01/20/2011.
Degree of Harm
- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health
Residents Affected
- Isolated
- Some Residents
- Many Residents
| Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Administration
Be Administered in a Way That Leads to the Highest Possible Level of Well Being for Each Resident.
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Get Services Outside the Nursing Home That Meet Professional Standards.
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Give or Get Lab Tests to Meet the Needs of Residents.
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Keep Accurate and Appropriate Medical Records.
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Keep Accurate and Appropriate Medical Records.
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Give or Get Lab Tests by a Certified Laboratory.
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Environmental
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
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Keep All Essential Equipment Working Safely.
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Nutrition and Dietary
Store, Cook, and Give out Food in a Safe and Clean Way.
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Pharmacy Service
Properly Mark Drugs and Other Similar Products.
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Quality Care
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
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Properly Care for Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, and Prostheses.
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Give Professional Services That Meet a Professional Standard of Quality.
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Deficiencies from Complaints and Incidents
The table below lists incident reports by the nursing staff or administration for The Elm's Nursing and Rehab Center, as well as complaints by residents or their family in the previous three years.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
| Formal Complaints | Degree of Harm | Residents Affected |
Administration
Keep Accurate and Appropriate Medical Records.
| | |
Mistreatment
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property.
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Protect Residents from Mistreatment, Neglect, And/Or Theft of Personal Property.
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1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.
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1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.
| | |
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property.
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Protect Residents from Mistreatment, Neglect, And/Or Theft of Personal Property.
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Quality Care
Give Professional Services That Meet a Professional Standard of Quality.
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Fire Safety
Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that The Elm's Nursing and Rehab Center had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 01/20/2011.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
| Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Automatic Sprinkler Systems
Properly Working Sprinkler Alarm System.
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Electrical
Properly Installed Electrical Wiring and Equipment.
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Emergency Plans and Fire Drills
Did Not Have a Written Emergency Evacuation Plan.
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Exits and Egress
Exits That Are Accessible at All Times.
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Hazardous Area
Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Miscellaneous
Fire Safety Features Required by Current Fire Safety Codes.
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Smoke Compartmentation and Control
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Proper Construction of Ducts Through Walls Designed to Prevent Smoke Passage.
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