Above average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Life Care Center Of Nashoba Valley during CMS and state inspections, most recent first.
A resident with severe cognitive impairment and multiple chronic conditions did not have a comprehensive, individualized care plan addressing all ADL needs. The care plan and Kardex lacked specific interventions and did not specify the required level of assistance for eating, despite staff observations and interviews confirming the resident's dependence on staff for several ADLs.
A resident with atrial fibrillation and hypertension had their anticoagulant medication changed from Coumadin to Eliquis, but the care plan was not updated to reflect this change. Despite two MDS assessments occurring after the medication switch, the care plan continued to reference the discontinued medication and related monitoring, and staff confirmed that the care plan should have been revised.
A licensed pharmacist did not complete the required monthly drug regimen review, including the medical chart, and the facility did not follow its own irregularity reporting guidelines as outlined in policy and procedure.
A resident with severe cognitive impairment was found to have a large tube of hemorrhoid cream left unsecured on a bureau in their room for several days. Facility policy requires all medications, including external treatments, to be stored in locked compartments. Staff confirmed the medication was not ordered for the resident and should not have been accessible, indicating a failure to follow proper medication storage procedures.
The facility failed to maintain resident dignity during dining in the Dementia Special Care Unit. Staff were observed conversing with each other about a resident's need for physical therapy, rather than engaging with the residents they were assisting. Additionally, staff were standing while assisting residents with eating, contrary to the facility's policy of sitting at eye level to promote dignity.
A resident with severe cognitive impairment and PICA was observed wearing a one-piece outfit with a back zipper, intended to prevent harmful behaviors. The facility did not assess whether the outfit constituted a physical restraint, as the resident could not remove it independently. Staff viewed the outfit as a behavior intervention, but no restraint assessment was documented in the resident's medical record.
A resident with severe cognitive impairment was transferred to the hospital without the necessary information being conveyed to the receiving provider. Despite standard procedures requiring the transmission of a face sheet, medication orders, and an e-interact form, the facility failed to provide these documents. Interviews with staff confirmed the absence of the required documentation, and the Director of Nursing acknowledged the oversight.
A resident in an LTC facility received medications without a proper physician order, and their spouse administered the medications without a self-administration assessment. The nurse failed to verify the order for Flonase nasal spray, and the facility's policy requiring nurses to stay with residents during medication administration was not followed.
A resident with severe cognitive impairment and physical limitations was not provided with the necessary supervision during breakfast meals, as required by their care plan. Observations showed the resident struggling to eat without staff assistance, despite needing supervision and setup help. Staff were not consistently present to provide the required support, and the Director of Nursing acknowledged the oversight.
A resident with severe cognitive impairment and a high risk for falls was observed without a functioning bed alarm, despite care plans and physician orders requiring its use. The bed alarm cord was found unplugged and stored in a drawer, indicating a failure to follow prescribed safety interventions.
During a lunch meal service, a cook failed to change gloves after opening the oven door, leading to food contamination. The cook handled fish, meatloaf, and a hot dog roll with the same gloves, which were deemed contaminated. The Food Service Director confirmed the need for glove changes after touching non-food surfaces.
Failure to Develop Comprehensive Person-Centered ADL Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan with individualized interventions for a resident with significant ADL (Activities of Daily Living) needs. The resident, admitted with diagnoses including Alzheimer's disease, COPD, and type 2 diabetes, was assessed as having severe cognitive impairment and required varying levels of assistance for oral hygiene, eating, toileting, dressing, personal hygiene, and was dependent for bathing. Observations showed staff assisting the resident with meal preparation but the care plan and Kardex did not specify the required level of assistance for eating. Interviews with staff confirmed reliance on the Kardex for guidance and acknowledged the resident's dependence on staff for multiple ADLs. Review of the resident's clinical record revealed a care plan that lacked specific, person-centered interventions for all ADL needs, only noting general deficits and some preferences. The care plan did not detail the level of assistance required for each ADL, such as eating, despite the resident's documented needs. Staff interviews further confirmed that the care plan was insufficiently detailed to inform staff of the resident's specific care requirements.
Care Plan Not Updated to Reflect Change in Anticoagulant Medication
Penalty
Summary
The facility failed to ensure that a resident's care plan was revised to accurately reflect the current anticoagulant medication regimen. Specifically, a resident with a history of hypertension and atrial fibrillation was initially on Coumadin therapy, which was discontinued in January 2025. The resident was subsequently prescribed Eliquis for anticoagulation, as indicated by physician orders dated February 2025. Despite these changes, the care plan continued to reference Coumadin therapy and related monitoring, such as INR and Protime, and was not updated to reflect the new medication regimen. Review of the resident's records showed that two Minimum Data Set (MDS) assessments were completed after the medication change, but the care plan was not revised accordingly. Interviews with facility staff confirmed that the care plan should have been updated during routine quarterly reviews and that nursing staff are responsible for making updates between MDS assessments. The discrepancy was identified during a review of the care plan and physician orders, and staff acknowledged that the care plan did not accurately reflect the resident's current anticoagulant therapy.
Failure to Ensure Monthly Pharmacist Drug Regimen Review
Penalty
Summary
A licensed pharmacist did not perform a monthly drug regimen review, including a review of the medical chart, as required. The facility also failed to follow its established policies and procedures for reporting irregularities identified during the drug regimen review process. This deficiency was identified through surveyor observation and documentation review.
Unsecured Medication Left in Resident Room
Penalty
Summary
A medication used to treat hemorrhoids was observed unsecured on a bureau in a resident's room over a period of three days. The facility's policy requires that all medications, including those for external use, be securely stored in a locked cabinet, cart, or medication room inaccessible to residents or visitors. The resident involved had severe cognitive impairment, as indicated by a low score on the Brief Interview of Mental Status, and was admitted with diagnoses including unspecified dementia, mixed incontinence, and type 2 diabetes mellitus. Multiple observations by the surveyor confirmed the presence of the large tube of hemorrhoid cream in the resident's room, and review of the resident's physician's orders did not show an order for this medication. Interviews with facility staff, including the Unit Manager and Assistant Director of Nursing, confirmed that all medications and treatments should be kept in locked storage and not in resident rooms, regardless of whether the medication is facility stock or brought in by family. Staff acknowledged that the tube of hemorrhoid cream was left out in the open and should have been removed, and that the resident did not have an order for its use. The failure to secure the medication and ensure it was not accessible to the resident constituted a violation of the facility's medication storage policy and professional standards of practice.
Failure to Maintain Resident Dignity During Dining
Penalty
Summary
The facility failed to maintain resident dignity during dining in the Dementia Special Care Unit. Observations revealed that staff members were conversing with each other across the room about a resident's need for physical therapy, rather than engaging with the residents they were assisting. This conversation occurred in the presence of approximately 20 residents, potentially compromising the privacy and dignity of the individuals involved. Additionally, staff were observed discussing concerns about another resident openly, which is against the facility's policy of maintaining resident dignity and privacy. Furthermore, staff members were observed standing while assisting residents with eating, rather than sitting at eye level as required by the facility's policy. This was noted during both breakfast and lunch meals, with one CNA admitting to standing while feeding residents due to the need to assist multiple individuals at different tables. The facility's policy emphasizes the importance of promoting resident independence and dignity during meals, which includes staff being at eye level with residents and engaging in conversation with them rather than with other staff members.
Failure to Assess Potential Restraint Use for Resident
Penalty
Summary
The facility failed to assess a resident for the use of a possible physical restraint. The resident, who has severe cognitive impairment and requires substantial assistance with daily activities, was observed wearing a snug-fitting one-piece outfit with a zipper at the back. This outfit was provided by the resident's family and was intended to prevent the resident from accessing their incontinence brief and ingesting non-food items due to PICA. However, the facility did not conduct a restraint assessment to determine if the outfit restricted the resident's freedom of movement, as the resident could not remove the outfit independently. Interviews with staff, including a CNA, an Activity Assistant, a Nurse, and the Unit Manager, revealed that the one-piece outfit was used as a behavior intervention to prevent the resident from engaging in harmful behaviors. Despite this, the staff did not consider the outfit as a potential restraint, and there was no documentation of a restraint assessment in the resident's medical record. The Director of Nursing acknowledged that the outfit was viewed as a behavior intervention rather than a restraint, indicating a lack of proper assessment and documentation in line with the facility's policy on physical restraint use.
Failure to Convey Necessary Information During Resident Transfer
Penalty
Summary
The facility failed to convey necessary information to the receiving provider when transferring a resident to the hospital. Resident #75, who was admitted to the facility in January 2021, has a medical history that includes depression, unspecified dementia, delusional disorder, transient ischemic attack, and cerebral infarction. The Minimum Data Set (MDS) assessment indicated that the resident has severely impaired cognition and requires substantial assistance for daily care. On 7/24/24, the resident was sent to the hospital following a medical doctor's recommendation for assessment, but the facility did not provide the required written conveyance of information to the hospital. Interviews with facility staff revealed that the standard procedure involves sending a face sheet, medication orders, advanced directive information, and an e-interact form with the resident. However, Unit Manager #3 could not find any documentation or e-interact form that was sent with the resident. The Director of Nursing confirmed that the only documentation in the medical record was a behavior note, and acknowledged that the nursing staff should have completed and sent the e-interact form to the hospital.
Failure to Follow Medication Administration Protocols
Penalty
Summary
The facility failed to adhere to professional standards of practice in medication administration for a resident, leading to a deficiency. Specifically, a nurse prepared and attempted to administer medications to a resident without verifying a physician's order for Flonase nasal spray, which was not found in the resident's medical record. The nurse acknowledged that the order might have dropped off and proceeded with the administration process without confirming the order's existence. Additionally, the resident expressed dissatisfaction with the medication administration process, indicating that their spouse typically administered the medications once brought to the room by the nurses. Further investigation revealed that the resident had not been assessed for self-administration of medication, and there was no documentation supporting such an assessment. The resident's spouse confirmed that she had been administering the medications, including eye drops, due to the nurses' time constraints. Interviews with the nurse, unit manager, and director of nursing confirmed that the facility's policy required nurses to remain with residents during medication administration unless a self-administration assessment had been completed, which was not done in this case.
Failure to Provide Supervision During Meals
Penalty
Summary
The facility failed to provide adequate supervision and assistance to a resident during breakfast meals, as required by the resident's care plan. The resident, who was admitted in December 2022, has severe cognitive impairment and requires supervision or touching assistance while eating. Observations on multiple occasions revealed that the resident was left alone with their breakfast tray, struggling to eat without staff assistance. Despite having a care plan that specified the need for supervision and setup help, staff were not present to provide the necessary support, leaving the resident to attempt eating independently with difficulty. The resident's medical records and care plan indicated a need for supervision during meals due to cognitive impairment and physical limitations. However, staff failed to consistently provide this supervision, as evidenced by the resident's incomplete meals and lack of staff presence during meal times. Interviews with staff confirmed that the resident requires cueing to eat, yet observations showed that staff only briefly checked in without providing sustained assistance. The Director of Nursing acknowledged that the resident should have been provided with the required supervision and assistance.
Failure to Implement Bed Alarm for High-Risk Resident
Penalty
Summary
The facility failed to implement interventions in accordance with the medical plan of care for a resident identified as high risk for falls. The resident, admitted in March 2021, has diagnoses including osteoporosis, unspecified dementia, and a history of repeated falls. The Minimum Data Set assessment indicated severe cognitive impairment and the need for substantial assistance with daily activities, with a bed alarm used daily as part of the care plan. Despite a physician's order and care plan specifying the use of a bed alarm at bedtime, observations on two occasions revealed that the bed alarm was not in use while the resident was in bed. On two separate observations, the bed alarm cord was found not plugged into the alarm box, rendering it non-functional. During an interview, a nurse confirmed the resident's care plan included the use of bed and chair alarms. The Unit Manager, upon entering the resident's room, also observed the bed alarm cord not connected to the alarm box, which was found in the resident's bedside drawer. This oversight indicates a failure to adhere to the prescribed safety interventions for the resident, who is at high risk for falls.
Improper Glove Use During Meal Service
Penalty
Summary
The facility failed to maintain sanitary conditions during the lunch meal service, as observed on 7/31/24. The cook, while wearing gloves, opened the oven door and then proceeded to handle food items, including fish, meatloaf, and a hot dog roll, without changing the gloves. This action led to the contamination of the food being served. The Food Service Director was informed of the improper glove use and acknowledged that the cook should have changed gloves after touching the oven door.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Littleton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Westford Nursing And Rehabilitation Center | 3.8 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Acton | 4.2 mi | ★★★★★ | 0 | 0 |
| Ayer Valley Rehab And Nursing | 5.2 mi | ★★★★★ | 0 | 0 |
| Seven Hills Pediatric Center | 7.3 mi | ★★★★★ | 13 | 0 |
| Rivercrest Long Term Care | 8 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.