SNF
TIMOTHY DANIELS HOUSE
CCN: 225709 · HOLLISTON, MA 01746 · Middlesex County
Overview
- Address
- 84 ELM STREET, HOLLISTON, MA 01746
- Phone
- 5084294566
- Certified beds
- 40
- Avg daily residents
- 33 (84% of beds filled)
- Ownership
- For-profit corporation
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 1996-08-01
- Setting
- Urban
3 /5
★★★★★
CMS Overall Rating
CMS 5-Star Ratings
CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.
Staffing & Workforce
Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.
| Role | Reported | Case-mix expected | Adjusted | Federal floor | |
|---|---|---|---|---|---|
| Total nurse All nursing staff combined: RN + LPN + Aide | 4.04 | 3.47 | 4.49 | ≥ 3.48 | |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.97 | 0.61 | 1.08 | ≥ 0.55 | |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 0.46 | 0.77 | 0.51 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 2.61 | 2.10 | 2.90 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.43 | — | — | — | |
| Physical therapist Rehabilitation therapist hours — important for post-acute / rehab admissions. | 0.07 | — | — | — |
Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.
Weekend staffing
Total nurse (weekend)
3.72
hrs / resident / day
RN (weekend)
0.70
hrs / resident / day
Total nurse (adjusted, weekend)
4.13
hrs / resident / day
Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.
Staff turnover
Total nursing staff turnover
37.5%
annual
RN turnover
28.6%
annual
Administrators departed
0
last 12 months
Resident acuity
Nursing Case-Mix Index
1.23
higher acuity than avg
Case-Mix Index Ratio
0.89
facility / state ratio
Health Inspections
CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.
| Cycle | Date | Total defs. | Standard | Complaint | Deficiency score | Revisits | Total score |
|---|---|---|---|---|---|---|---|
| Cycle 1 (most recent) | 2025-03-06 | 17 | 16 | 1 | 112 | 1 | 112 |
| Cycle 2/3 (prior) | 2024-02-16 | 9 | 9 | 0 | 64 | 1 | 64 |
Total weighted health score
100.0
lower is better
Deficiencies (35)
Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).
2 A/B/C No actual harm — minor
33 D/E/F Actual harm — potential for minor
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2025-11-25 | 2025-12-19 |
| 0558 | Reasonably accommodate the needs and preferences of each resident. | D | 2025-03-06 | 2025-04-05 |
| 0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | 2025-03-06 | 2025-04-05 |
| 0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | 2025-03-06 | 2025-04-05 |
| 0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | 2025-03-06 | 2025-04-05 |
| 0604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | E | 2025-03-06 | 2025-04-05 |
| 0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | B | 2025-03-06 | 2025-03-25 |
| 0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | 2025-03-06 | 2025-04-05 |
| 0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | 2025-03-06 | 2025-04-05 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2025-03-06 | 2025-04-05 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2025-03-06 | 2025-04-05 |
| 0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | F | 2025-03-06 | 2025-04-05 |
| 0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | 2025-03-06 | 2025-04-05 |
| 0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | 2025-03-06 | 2025-04-05 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2025-03-06 | 2025-04-05 |
| 0880 | Provide and implement an infection prevention and control program. | F | 2025-03-06 | 2025-04-05 |
| 0881 | Implement a program that monitors antibiotic use. | E | 2025-03-06 | 2025-04-05 |
| 0641 | Ensure each resident receives an accurate assessment. | B | 2024-02-16 | 2024-03-26 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | 2024-02-16 | 2024-03-26 |
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2024-02-16 | 2024-03-28 |
| 0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | 2024-02-16 | 2024-03-15 |
| 0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2024-02-16 | 2024-03-22 |
| 0880 | Provide and implement an infection prevention and control program. | F | 2024-02-16 | 2024-03-28 |
| 0881 | Implement a program that monitors antibiotic use. | E | 2024-02-16 | 2024-03-26 |
| 0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | 2024-02-16 | 2024-03-28 |
| 0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | E | 2024-02-16 | 2024-03-28 |
| 0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2022-08-02 | 2022-09-16 |
| 0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | 2022-08-02 | 2022-09-16 |
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | 2022-08-02 | 2022-09-16 |
| 0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2022-08-02 | 2022-09-16 |
| 0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | 2022-08-02 | 2022-09-16 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2022-08-02 | 2022-09-16 |
| 0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | F | 2022-08-02 | 2022-09-16 |
| 0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | 2022-08-02 | 2022-09-16 |
| 0908 | Keep all essential equipment working safely. | E | 2022-08-02 | 2022-09-16 |
Penalties (1)
Fines issued
0
last 3 years
Payment denials
1
| Date | Type | Fine amount |
|---|---|---|
| 2024-02-16 | Payment Denial | — |
Source: CMS Nursing Home Penalties.
Financial Health (FY 2023)
Payer mix (share of resident days)
Medicare 9.0% Medicaid 72.2% Other 18.8%
Operating performance
Operating Margin
-6.4%
Total Margin
-2.8%
Occupancy Rate
79.1%
Cost per Resident Day
$20
Revenue & costs
Net Patient Revenue
$4.0M
Total Costs
$232K
Net Income
-$116K
Balance sheet
Total Assets
$6.3M
Total Liabilities
$6.5M
Fund Balance
-$202K
Current Ratio
11.59
Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Chain: REHABILITATION ASSOCIATES
- Chain ID
445- Facilities in chain
- 6
- Legal business name
- 84 ELM ST INC.
Chain-average star ratings (for peer context)
Overall
3.2
Health
3.0
Staffing
4.0
QM
3.0
Owner / manager organizations (1)
| Organization | Role | Association |
|---|---|---|
| REHABILITATION ASSOCIATES INC | OPERATIONAL/MANAGERIAL CONTROL | since 05/24/1972 |
Owner / manager individuals (3)
| Name | Role | Association |
|---|---|---|
| THISSE, MARION | 5% OR GREATER DIRECT OWNERSHIP INTEREST | since 03/14/2024 |
| BUNKER, THOMAS | OPERATIONAL/MANAGERIAL CONTROL | since 05/13/2016 |
| THISSE, PETER | CORPORATE DIRECTOR | since 01/02/1990 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- No
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Partial
- Abuse citation flag
- No
Methodology & sources
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Penalties (
nh-penalties), vintage 2026, downloaded 2026-04-14 , 16,915 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2023, downloaded 2026-04-14 , 14,120 rows.
All Data
Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.
Show 113 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $20 | metrics.cost_per_resident_day |
| Cost Report | Current Ratio | 11.59 | metrics.current_ratio |
| Cost Report | fiscal_year | 2,023 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 72.2% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 9.0% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $-116,075 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $3,985,168 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 79.1% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | -6.4% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $6,335,890 | metrics.total_assets |
| Cost Report | Total Costs ($) | $232,383 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $-202,252 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $6,538,142 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | -2.8% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 0.51216 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 2.89704 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 1.07960 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 4.48880 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 4.13232 | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Administrator turnover footnote | — | Administrator turnover footnote |
| Provider Information | Automatic Sprinkler Systems in All Required Areas | Partial | Automatic Sprinkler Systems in All Required Areas |
| Provider Information | Average Number of Residents per Day | 33.4 | Average Number of Residents per Day |
| Provider Information | Average Number of Residents per Day Footnote | — | Average Number of Residents per Day Footnote |
| Provider Information | Case-Mix LPN Staffing Hours per Resident per Day | 0.77108 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 2.09562 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.60778 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 3.47448 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 3.06239 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | 3.0 | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | 3.2 | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | 3.0 | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | 4.0 | Chain Average Staffing Rating |
| Provider Information | Chain ID | 445 | Chain ID |
| Provider Information | Chain Name | REHABILITATION ASSOCIATES | Chain Name |
| Provider Information | City/Town | HOLLISTON | City/Town |
| Provider Information | CMS Certification Number (CCN) | 225709 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | N | Continuing Care Retirement Community |
| Provider Information | County/Parish | Middlesex | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 1996-08-01 | Date First Approved to Provide Medicare and Medicaid Services |
| Provider Information | Geocoding Footnote | — | Geocoding Footnote |
| Provider Information | Health Inspection Rating | 2 | Health Inspection Rating |
| Provider Information | Health Inspection Rating Footnote | — | Health Inspection Rating Footnote |
| Provider Information | Latitude | 42.2021 | Latitude |
| Provider Information | Legal Business Name | 84 ELM ST INC. | Legal Business Name |
| Provider Information | Location | 84 ELM STREET,HOLLISTON,MA,01746 | Location |
| Provider Information | Long-Stay QM Rating | 2 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -71.425 | Longitude |
| Provider Information | Most Recent Health Inspection More Than 2 Years Ago | N | Most Recent Health Inspection More Than 2 Years Ago |
| Provider Information | Number of administrators who have left the nursing home | 0 | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 40 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | — | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | 6 | Number of Facilities in Chain |
| Provider Information | Number of Fines | 0 | Number of Fines |
| Provider Information | Number of Payment Denials | 1 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.23085 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 0.89345 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 3 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | For profit - Corporation | Ownership Type |
| Provider Information | Physical Therapist Staffing Footnote | — | Physical Therapist Staffing Footnote |
| Provider Information | Processing Date | 2026-03-01 | Processing Date |
| Provider Information | Provider Address | 84 ELM STREET | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | TIMOTHY DANIELS HOUSE | Provider Name |
| Provider Information | Provider Resides in Hospital | N | Provider Resides in Hospital |
| Provider Information | Provider SSA County Code | 090 | Provider SSA County Code |
| Provider Information | Provider Type | Medicare and Medicaid | Provider Type |
| Provider Information | QM Rating | 3 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 112 | Rating Cycle 1 Health Deficiency Score |
| Provider Information | Rating Cycle 1 Health Revisit Score | 0 | Rating Cycle 1 Health Revisit Score |
| Provider Information | Rating Cycle 1 Number of Complaint Health Deficiencies | 1 | Rating Cycle 1 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 1 Number of Health Revisits | 1 | Rating Cycle 1 Number of Health Revisits |
| Provider Information | Rating Cycle 1 Number of Standard Health Deficiencies | 16 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2025-03-06 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 112 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 17 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 9 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2024-02-16 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 64 | Rating Cycle 2/3 Health Deficiency Score |
| Provider Information | Rating Cycle 2/3 Health Revisit Score | 0 | Rating Cycle 2/3 Health Revisit Score |
| Provider Information | Rating Cycle 2/3 Number of Complaint Health Deficiencies | 0 | Rating Cycle 2/3 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 2/3 Number of Health Revisits | 1 | Rating Cycle 2/3 Number of Health Revisits |
| Provider Information | Rating Cycle 2/3 Total Health Score | 64 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 9 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.69518 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 28.6 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.43244 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 0.46089 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 2.60707 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.07337 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.97154 | Reported RN Staffing Hours per Resident per Day |
| Provider Information | Reported Staffing Footnote | — | Reported Staffing Footnote |
| Provider Information | Reported Total Nurse Staffing Hours per Resident per Day | 4.03951 | Reported Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Short-Stay QM Rating | 4 | Short-Stay QM Rating |
| Provider Information | Short-Stay QM Rating Footnote | — | Short-Stay QM Rating Footnote |
| Provider Information | Special Focus Status | — | Special Focus Status |
| Provider Information | Staffing Rating | 5 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | MA | State |
| Provider Information | Telephone Number | 5084294566 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 0.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 3.71871 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 1 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 37.5 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 100.000 | Total Weighted Health Survey Score |
| Provider Information | Urban | Y | Urban |
| Provider Information | With a Resident and Family Council | Resident | With a Resident and Family Council |
| Provider Information | ZIP Code | 01746 | ZIP Code |