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
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.
Water Management Program Not Updated or Implemented as Written: The facility failed to update its Water Management Program and did not implement required control measures for water outlets, closed drinking fountains, or resident humidifiers. Surveyors observed two lobby drinking fountains, learned they had been turned off and unused for months, and found empty rooms were flushed monthly instead of daily. An LPN confirmed a resident had a humidifier, and the IP stated resident humidifiers were filled with distilled water rather than the sterile water described in the program.
A resident kept a Phenylephrine HCL 1% nasal spray on the bedside table and said he/she used it every night after buying it months earlier. Staff confirmed the medication was at the bedside, but the chart showed no MD order and no assessment for self-administration. The DON confirmed the resident had not been assessed to self-administer the nasal spray.
A resident reported that a staff member was rude and condescending during a dining room incident witnessed by others, and the resident’s spouse described the staff member as standing over the resident and speaking in an aggressive, escalating tone. An LPN said the event was reported immediately to the ADON, but the ADON did not notify the administrator, and the facility’s initial report to the SSA was submitted late.
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.
Water Management Program Not Updated or Implemented as Written
Penalty
Summary
The facility failed to update its Water Management Program and failed to implement control measures to prevent the growth and spread of Legionella and other opportunistic waterborne pathogens. Review of the Water Management Program dated January 2023 showed no revisions or updates and no identification of the two drinking water fountains in the facility lobby. The program also included a control measure to run hot and cold water outlets daily in unoccupied resident rooms, and a control measure stating that resident humidifiers, if brought by patients, should be disinfected daily and filled only with sterile water. Observation of the lobby showed two drinking water fountains, and staff later stated the fountains had been turned off at the fixture and had not been in use since November 2025. Staff also stated that empty rooms were flushed monthly rather than daily, and there were no control measures in place for the closed drinking fountains. In Resident #16's room, surveyors observed a humidifier with a sign indicating it should be filled with distilled water only. Staff confirmed the resident had a humidifier, and the Infection Preventionist stated resident humidifiers were filled with distilled water rather than sterile water as described in the Water Management Plan. The Infection Preventionist also confirmed there had been no updates or revisions to the Water Management Program within the past year.
Failure to Assess Self-Administration of Bedside Medication
Penalty
Summary
The facility failed to ensure that a resident was assessed to self-administer medication. During observation, a Phenylephrine HCL 1% nasal spray with an expiration date of 10/25 was found on the resident’s bedside table. The resident stated that he/she used the nasal spray every night and had left it on the bedside table after purchasing it months earlier. Staff confirmed the nasal spray was present at the bedside. Review of the resident’s medical record showed there was no physician’s order for the nasal spray and that the resident had not been assessed to self-administer medication. The DON confirmed that the resident was not assessed to self-administer medication and did not have a physician’s order for the nasal spray. The facility policy stated that a resident may only self-administer medications after the interdisciplinary team has determined which medications may be self-administered safely and that the assessment results are to be recorded in the medical record.
Late Reporting of Alleged Abuse Incident
Penalty
Summary
The facility failed to ensure that an alleged abuse incident involving a resident was reported timely to the State Survey Agency. Resident #137 reported that a staff member was rude and condescending during an incident in the dining room that occurred in front of other residents and family members. During interview, the resident became teary and emotional while recounting the event, and the resident’s spouse stated that the staff member was standing over the resident and speaking in an aggressive, escalating tone. Staff N, an LPN, stated that the incident was reported immediately to Staff L, the ADON. Staff L acknowledged being made aware of the incident on 5/27/26 at approximately 2:30 p.m. but did not report it to the administrator. The facility’s initial report to the SSA was not submitted until 5/29/26. The Administrator confirmed that the alleged violation was reported late to the SSA.
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Compliance trends in New Hampshire
Data through May 2026Comparisons below measure the most recent period Jun 2025 – May 2026 against the prior period Jun 2024 – May 2025 (two equal 12-month windows). The most recent 2 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 2-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): Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025. Only tags with at least 20 citations in both periods are shown.
Severity movers
Tags whose average scope/severity shifted the most: Jun 2025 – May 2026 vs the prior period Jun 2024 – May 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: Jun 2025 – May 2026 vs the prior period Jun 2024 – May 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 Jun 2025 – May 2026 vs the prior period Jun 2024 – May 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 2 months are still being reported.
Deficiency-free survey rate
Share of health surveys that found zero deficiencies — the odds of a clean survey. Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025; the most recent 2 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 2 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
Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release August 26, 2026) and official state health department websites — never guesswork.
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