Citations in New Hampshire
Statistics, citations and compliance trends for long-term care facilities in New Hampshire.
Statistics for New Hampshire (Last 12 Months)
Financial Impact (Last 12 Months)
Latest citations in New Hampshire
The facility failed to store food in accordance with food safety standards in multiple kitchenette and dining room refrigerators. Temperature logs showed repeated readings above the required range, including temperatures up to 57 degrees F, and the Dietary Manager confirmed there was no documentation that temperatures were rechecked on the affected days. Facility policy required refrigerators to be at or below 41 degrees F, and FDA guidance stated they should be kept at 40 degrees F or below.
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.
Activities Program Not Directed by a Qualified Professional: The facility failed to ensure the activities program was directed by a qualified professional for a census of 106 residents. The Activities Director had previously worked as the front desk receptionist and was on leave, and the Administrator stated that neither the Activities Director nor the Administrator had the qualifications required to direct the program. The Administrator was covering the role and had education in Psychology, Business, Public Administration, and Health Care, but no experience in a social, recreational, or therapeutic activities program.
Failure to document and review pharmacy DRR/MRR recommendations: multiple residents had pharmacist notes referencing comments or recommendations that were not available in the medical record, and the DON could not confirm provider review. For another resident, the pharmacist questioned a metoprolol order, but the provider only signed the review without documenting acceptance, rejection, or rationale.
Improper Refrigerator Temperature Monitoring and Food Storage
Penalty
Summary
The facility failed to store food in accordance with professional standards for food service safety in 3 of 5 kitchenette refrigerators and 1 of 3 dining room refrigerators observed for a census of 109 residents. Review of refrigerator temperature logs showed multiple temperatures above the required range in the 2nd Floor Annex refrigerator, the 2nd Floor East refrigerator, the 4th Floor Resident Dining Room refrigerator, and the 4th Floor Kitchenette refrigerator, including readings as high as 57 degrees F and 50 degrees F. During interview, the Dietary Manager confirmed the findings and stated there was no documentation that temperatures were rechecked on the noted days. The facility policy stated all refrigerators will be at or below 41 degrees F, and the FDA guidance reviewed stated refrigerator temperature should be kept at 40 degrees F or below.
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.
Activities Program Not Directed by a Qualified Professional
Penalty
Summary
The facility failed to ensure that its activities program was directed by a qualified professional for a census of 106 residents. During interview, the Administrator stated that the Activities Director started in mid-May 2026 but had been on leave since the beginning of June 2026, and that this staff member did not have the qualifications required to direct the activities program. The Administrator also stated that the Activities Director had previously worked as the front desk receptionist and that the facility was registering the staff member for an activities training program in the fall. The Administrator further stated that they were covering for the Activities Director, but also acknowledged that they did not have the qualifications required to direct the activities program. Review of the Administrator’s resume showed education in Psychology, Business, Public Administration, and Health Care, but no experience in a social or recreational program or therapeutic activities program.
Failure to Document and Review Pharmacy Drug Regimen Recommendations
Penalty
Summary
The facility failed to ensure that irregularities identified by the pharmacist during monthly Drug Regimen Reviews (DRRs) were reviewed by the provider and that the provider documented a rationale for the action taken on the pharmacy recommendations. For Resident #8, a pharmacy DRR note dated 11/21/25 referenced comments/recommendations, but the medical record contained no DRR recommendation and the DON stated the recommendation was not available and she did not know what it was or whether it had been reviewed by the medical provider. For Resident #1, a DRR note dated 4/23/26 also stated "see report for comments/recommendations," but there was no documentation of the recommendation in the medical record, and the DON again stated the recommendation was not available and she did not know whether it had been reviewed. For Resident #6, DRR notes dated 3/24/26, 4/24/26, and 5/23/26 each stated "see report for comments/recommendations," but the medical record contained no documentation of those recommendations, and the DON stated she did not know what the recommendations were or whether they had been reviewed by the medical provider. For Resident #30, the pharmacy MRR recommended clarifying metoprolol tartrate 12.5 mg once daily versus metoprolol succinate ER once daily, but the provider only wrote "Reviewed and signed" and did not indicate whether the recommendation was accepted or declined or document a rationale. The resident’s active order remained metoprolol tartrate 12.5 mg once daily, and the medical record contained no provider rationale for why the order was not changed.
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Compliance trends in New Hampshire
Data through Jun 2026Comparisons below measure the most recent period Jul 2025 – Jun 2026 against the prior period Jul 2024 – Jun 2025 (two equal 12-month windows). The most recent 1 months are excluded because CMS is still publishing them.
Top tags by month · last 24 months
dashed = still reportingMonthly citation counts for the 5 most-cited tags. The dashed tail is the 1-month reporting lag.
Frequency movers
Biggest change in how often each tag is cited, as a rate per 100 inspections (so it isn't skewed by survey volume): Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. Only tags with at least 20 citations in both periods are shown.
Severity movers
Tags whose average scope/severity shifted the most: Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. The number is the average severity on the A–L scale (A=0…L=11); the letter is the band it falls in. A rise means the same tag is being cited at a more serious level — note the average can move enough to rank here while staying within the same letter. Same 20-citation minimum applies.
Care domain movers
Citations grouped into CFR care domains — F-tags by their §483 regulatory section (CMS State Operations Manual, Appendix PP) — measured as a rate per 100 inspections: Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. Share is the domain's portion of citations this period; avg severity is the mean scope/severity letter and immediate jeopardy the percentage cited at J–L, both over the current period. Domains with at least 20 citations in both periods are shown; the sparkline tracks the last 12 months (left = oldest).
Immediate jeopardies · this period
Citations at the most serious scope/severity — J–L, immediate jeopardy, residents placed at risk of serious harm or death — over Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025. "Surveys with an IJ" counts distinct health inspections that had at least one.
Survey activity · by month
faded/dashed = still reportingCitations each month split into complaint-driven (unscheduled, triggered by grievances) vs standard surveys — bars, left axis — with the number of inspections as a line on the right axis. Rising inspections signal more scrutiny; a rising complaint share means more off-cycle surveys. The most recent 1 months are still being reported.
Deficiency-free survey rate
Share of health surveys that found zero deficiencies — the odds of a clean survey. Jul 2025 – Jun 2026 vs the prior period Jul 2024 – Jun 2025; the most recent 1 months are still being reported (dashed).
Penalties · by month
faded = still reportingTotal civil money penalty dollars imposed on the state's facilities each month — how hard the state is enforcing. The most recent 1 months are still being reported, and penalties often lag citations by several months.
Emerging tags
Tags that weren't established last period but surged — an early warning, distinct from movers (which track already-common tags). Criteria: fewer than 20 citations in the prior period, but at least 10 this period and 2.5× their prior volume. The sparkline shows monthly counts over the last 12 months (left = oldest).
No tags meet the emerging criteria for this period — nothing rare is spiking right now.
Trusted data from CMS and state health departments
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