Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Courville At Nashua during CMS and state inspections, most recent first.
A resident had an active PRN order for Lorazepam for agitation that exceeded the 14-day limit for psychotropic medications. The DON confirmed the order was over 14 days, and the PA stated there was no documented rationale for the medication in the clinical record.
Hand hygiene and EBP were not followed during resident care. An LPN administering IV cefazolin to a resident with a PICC line picked up a saline flush from the floor with an ungloved hand, changed gloves without hand hygiene, and continued IV prep and infusion tasks. In a separate event, an LNA transferred a resident with stage 3 pressure ulcers and removed linens while wearing gloves but no gown, despite EBP signage requiring both PPE items for those high-contact activities.
The facility failed to provide written bed-hold notice to two residents at the time of hospital transfer. One resident was admitted for skilled services and had multiple hospital transfers without documentation of a bed-hold notice, and another resident was sent to the hospital for evaluation without receiving the required notice. Staff confirmed the notices were not provided because the facility does not give written bed-hold notice for residents transferred to the hospital.
The facility did not implement or annually review its water management program, failing to specify or document control measures for multiple at-risk areas such as water heaters, pipes, faucets, and medical equipment. Key staff could not identify the standards used to develop the program, and the Legionella Policy had not been updated since 2018, potentially affecting all residents.
Surveyors observed a greenish brown film inside the main kitchen ice machine, confirmed by the Food Service Director, indicating a lack of proper cleaning and sanitization as required by the manufacturer's instructions. In a satellite kitchenette, five supplemental shakes were found with handwritten use by dates, and the Food Service Director confirmed these dates corresponded to the 14-day use period from thawing, as specified by product instructions.
A resident with advanced Parkinson's Disease was admitted with a communication board to aid in communication, but the device was not accessible, leading to communication difficulties. The resident's DPOA reported the board missing, and staff interviews revealed a lack of awareness and initial inability to locate the device, which was eventually found in a drawer in the resident's room.
A facility failed to provide appropriate treatment to maintain mobility for a resident with limited range of motion. The care plan required a rolled face cloth in the resident's right hand to prevent pressure injury, but observations showed the resident's hand was clenched without the cloth. A staff member was unaware of this requirement, and the resident's physical therapy goal of tolerating the cloth for at least eight hours was not being met.
A facility failed to coordinate effectively with a hospice company for a resident's care. The hospice care plan required three weekly visits, but documentation showed only one visit per week initially. Interviews confirmed the absence of a visit schedule, leading to inconsistent documentation and visit frequency.
The facility did not follow its contact precautions policy for a resident with CDiff. An LPN entered the resident's room without wearing a gown and gloves while administering medications, contrary to the facility's policy. The Unit Manager/Infection Preventionist confirmed the requirement for PPE use, as outlined in the Infection Prevention and Control Program.
The facility failed to notify two residents' DPOAs about care plan meetings, preventing their participation in care planning. Both DPOAs expressed a desire to attend meetings but were not informed or invited, and no documentation was found in the residents' medical records. Staff confirmed the lack of notification, contrary to the facility's policy encouraging representative involvement.
PRN Psychotropic Order Exceeded 14-Day Limit
Penalty
Summary
The facility failed to ensure that a PRN order for a psychotropic medication was limited to 14 days for Resident #5. Review of the resident’s MAR showed an active order for Lorazepam 0.5 mg by mouth every 4 hours as needed for agitation, with a start date of 6/12/26. During interview, the DON confirmed that the Lorazepam order was greater than 14 days, and the PA stated that no rationale for the Lorazepam had been documented in the clinical record. The facility policy reviewed by surveyors stated that psychotropic medications are not to be prescribed or given on a PRN basis unless necessary to treat a diagnosed specific condition documented in the clinical record, and that PRN orders for psychotropic medications are limited to 14 days.
Hand Hygiene and EBP Not Followed During Resident Care
Penalty
Summary
The facility failed to follow its hand hygiene and glove-use policies during IV antibiotic administration for a resident with a left knee infection and a PICC line. During medication administration, an LPN entered the room wearing a gown and no gloves while carrying clean gloves, an IV antibiotic bag, saline flushes, alcohol wipes, and IV tubing. After a saline flush fell to the floor, the LPN picked it up with an ungloved hand and placed it on a dresser, moved the resident’s belongings, donned clean gloves without performing hand hygiene, and cleaned the bedside table with bleach wipes. The LPN later removed gloves and put on new gloves without hand hygiene after flushing the PICC line, attaching the IV antibiotic, priming the tubing, and threading it to the IV pump, then labeled the tubing. The facility also failed to follow enhanced barrier precautions for a resident with stage 3 pressure ulcers and an order for EBP related to wounds. A posted sign at the resident’s room specified that staff must wear gloves and a gown for high-contact care activities including transferring and changing linens. During observation, an LNA transferred the resident from bed to wheelchair wearing gloves but no gown, and then removed the linens from the resident’s bed while still wearing gloves and no gown. The infection preventionist confirmed that gowns and gloves should be worn for residents on EBP during high-contact activities such as transferring and changing linens.
Failure to Provide Written Bed-Hold Notice at Hospital Transfer
Penalty
Summary
The facility failed to provide written bed-hold notice at the time of hospital transfer for 2 of 2 residents reviewed for hospitalizations. Resident #4 was admitted for skilled services and was transferred to the hospital on 3/9/26, 4/28/26, and 6/25/26, but there was no documentation that a written bed-hold notice was provided at the time of any of those transfers. Resident #4 confirmed during interview that they did not receive a written bed-hold notice related to the hospital transfers. Resident #23 was sent to the hospital for evaluation on 6/9/26, and there was no documentation that a written bed-hold notice was provided at the time of transfer. Staff A confirmed that Resident #23 was not provided a written bed-hold notice at the time of the hospital transfer, and later confirmed that Resident #4 and Resident #23 were not provided written bed-hold notices for the hospital transfers because the facility does not provide written bed-hold notice for residents transferred to the hospital.
Failure to Implement and Review Water Management Program for Infection Control
Penalty
Summary
The facility failed to implement and annually review its water management program, which is required for infection prevention and control. A review of the facility's Water Management Program revealed that multiple at-risk areas were identified, including water heaters, expansion tanks, pipes, valves, fittings, faucets, shower heads, air washers, humidifiers, eyewash stations, ice machines, CPAP machines, oxygen bubblers, nebulizers, hydrotherapy equipment, heater-cooler units, and water filters. However, the program did not specify what control measures would be applied or monitored for these at-risk areas. Interviews with the Maintenance Director and Infection Preventionist confirmed that there was no documentation of control measures for the identified areas, and neither staff member could identify the nationally-recognized standard used to develop the water management program. Further review showed that the facility's Legionella Policy had not been reviewed or updated since 2018, and there was no documentation that the Water Management Plan had been discussed at a committee meeting. The Administrator confirmed the absence of documentation regarding the application and monitoring of control measures and acknowledged that the policy had not been reviewed since 2018. The deficiency had the potential to affect all 69 residents residing in the facility.
Unsanitary Kitchen Equipment and Improper Food Handling
Penalty
Summary
The facility failed to ensure that kitchen equipment was clean and sanitary and that food was handled according to professional standards. During an observation of the main kitchen, a greenish brown film was found inside the ice machine below the ice cube metal grid, and this was confirmed by the Food Service Director. Review of the manufacturer's instructions indicated that the ice machine should be cleaned and sanitized every six months. Additionally, in a first floor satellite kitchenette, five supplemental shakes were found in the refrigerator with a handwritten use by date, which was confirmed by the Food Service Director to be the 14th day from the thaw date. The product instructions required that thawed product be used within 14 days and kept refrigerated.
Failure to Maintain Resident's Communication Ability
Penalty
Summary
The facility failed to maintain a resident's ability to communicate by not ensuring the availability of a communication device. A resident with advanced Parkinson's Disease, who was admitted with a communication board to aid in communication, was unable to use the device as it was not accessible. The resident's Durable Power of Attorney (DPOA) reported that the communication board had not been seen since shortly after admission. Staff interviews revealed that some staff members were unaware of the communication board, while others confirmed its existence but could not locate it initially. Eventually, the communication board was found in a drawer in the resident's room. The resident expressed difficulty in communicating with staff without the board.
Failure to Maintain Mobility Treatment for Resident
Penalty
Summary
The facility failed to ensure that a resident received appropriate treatment to maintain mobility, specifically for a resident with limited range of motion. The care plan for the resident included an intervention to prevent pressure injury by placing a rolled face cloth in the resident's right hand, which was to be changed with care and reapplied if removed. However, observations on multiple occasions revealed that the resident's right hand was clenched without the rolled face cloth in place. An interview with a Licensed Nursing Assistant indicated a lack of awareness regarding the requirement for the resident to have a rolled face cloth in their right hand. The Physical Therapy Discharge Summary had previously set a goal for the resident to tolerate a folded/rolled wash cloth in the right hand for at least eight hours without skin integrity issues or pain, which was not being met.
Lack of Coordination with Hospice Services
Penalty
Summary
The facility failed to ensure effective collaboration and communication with a hospice company for a resident receiving hospice care. The resident was admitted to hospice services, and the care plan specified that a hospice aide should visit three times a week for nine weeks. However, documentation revealed that during the first week, only one visit was recorded, and during the second week, only one visit was documented despite the aide claiming to have visited three times. Interviews with the unit manager and the hospice aide confirmed the lack of a schedule for hospice visits, contributing to the inconsistency in visit documentation and frequency.
Failure to Follow Contact Precautions for CDiff
Penalty
Summary
The facility failed to adhere to its policy on contact precautions, specifically for a resident on transmission-based precautions due to Clostridium Difficile (CDiff) infection. During an observation, a Licensed Practical Nurse (LPN) was seen entering the resident's room without wearing the required personal protective equipment (PPE), such as a gown and gloves, while administering medications. The LPN admitted to not using PPE when not providing direct care, despite the resident being on contact precautions. The Unit Manager/Infection Preventionist confirmed that the facility's policy mandates the use of a gown and gloves before entering rooms with transmission-based precautions for CDiff. A review of the facility's Infection Prevention and Control Program corroborated this requirement.
Failure to Notify Residents' Representatives of Care Plan Meetings
Penalty
Summary
The facility failed to notify residents and/or their representatives about care plan meetings, as evidenced by the cases of two residents. For Resident #16, the activated Durable Power of Attorney (DPOA) reported not being invited to any care plan meetings for over six months, despite expressing a desire to attend and contribute to the resident's care. A review of Resident #16's medical records confirmed the absence of documentation regarding care plan meeting notifications to the DPOA. Staff J, a social worker, corroborated the lack of documentation for the period from December 2023 through May 2024. Similarly, Resident #40's DPOA was unaware of care plan meetings and had not received any invitations, despite being present at the facility almost daily. The DPOA expressed a willingness to participate in the meetings to discuss the resident's care. A review of Resident #40's medical records also showed no documentation of care plan meeting notifications. Staff J confirmed the absence of such documentation. The facility's policy, revised in March 2022, encourages resident and representative participation in care plan development and requires documentation if participation is deemed impracticable, which was not adhered to in these cases.
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What surveyors actually found near you
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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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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Nashua
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Nashua Post Acute Care | 1 mi | ★★★★★ | 13 | 0 |
| Fairview Nursing Home | 2.6 mi | ★★★★★ | 16 | 0 |
| D'youville Care For Advanced Therapy | 8.7 mi | ★★★★★ | 0 | 0 |
| Northwood Rehabilitation & Healthcare Center | 8.9 mi | ★★★★★ | 0 | 0 |
| D'youville Senior Care | 9 mi | ★★★★★ | 27 | 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 August 2026) and official state health department websites.