Cycle 1
Health 2025-05-14 · Fire 2025-05-14
3 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
8 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Livingston, TN
Overton County Health And Rehab Center
4-star overall rating with 4-star inspections with 3 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
318 Bilbrey Street, Livingston, TN
(931) 823-6403
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
125
Certified beds
Average residents
87
Average occupied residents
Ownership
Government
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
2000-07-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.30
Registered nurse staffing · state 0.61 · national 0.68
LPN hours / resident day
1.08
Licensed practical nurse staffing · state 1.09 · national 0.87
Aide hours / resident day
2.53
Nurse aide staffing · state 2.15 · national 2.35
Total nurse hours
3.92
All reported nurse hours · state 3.85 · national 3.89
Licensed hours
1.39
RN + LPN hours · state 1.70 · national 1.54
Weekend hours
3.52
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.10
Weekend registered nurse coverage · state 0.40 · national 0.47
Physical therapist
0.04
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.35
CMS adjusted RN staffing hours
Adjusted total hours
4.45
CMS adjusted total nurse staffing hours
Case-mix index
1.20
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
31%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
3,791
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
42.66
Composite VBP score used to determine payment impact.
Payment multiplier
0.9956
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.40
Baseline 17.90% · Performance 19.85% · Measure score 3.40 · Achievement 3.40 · Improvement 0
Healthcare-associated infections
0
Baseline 6.08% · Performance 9.24% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
8.59
Baseline 31.15% · Performance 28.57% · Measure score 8.59 · Achievement 8.59 · Improvement 3.59
Adjusted total nurse staffing
5.07
Baseline 4.20 hours · Performance 4.52 hours · Measure score 5.07 · Achievement 5.07 · Improvement 1.51
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.99% |
10.72%
0.7 pts better
|
No Different than the National Rate · Eligible stays 198 · Observed rate 8.59% · Lower 95% interval 7.49% |
| Discharge to community | 49.31% |
50.57%
1.3 pts worse
|
No Different than the National Rate · Eligible stays 200 · Observed rate 44.5% · Lower 95% interval 42.85% |
| Medicare spending per beneficiary | 0.96 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 94.07% |
95.27%
1.2 pts worse
|
Numerator 127 · Denominator 135 |
| Falls with major injury | 0.74% |
0.77%
About the same
|
Numerator 1 · Denominator 135 |
| Discharge self-care score | 23.86% |
53.69%
29.8 pts worse
|
Numerator 21 · Denominator 88 |
| Discharge mobility score | 14.77% |
50.94%
36.2 pts worse
|
Numerator 13 · Denominator 88 |
| Pressure ulcers or injuries, new or worsened | 2.24% |
2.29%
About the same
|
Numerator 3 · Denominator 134 · Adjusted rate 2.17% |
| Healthcare-associated infections requiring hospitalization | 9.24% |
7.12%
2.1 pts worse
|
No Different than the National Rate · Eligible stays 132 · Observed rate 10.61% · Lower 95% interval 6.09% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 112 |
| Staff flu vaccination coverage | Not Available |
42%
|
Numerator Not Available · Denominator Not Available · No data were submitted for this measure. |
| Discharge function score | 26.14% |
56.45%
30.3 pts worse
|
Numerator 23 · Denominator 88 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 84 · Denominator 84 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 18 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 12.82% |
25.2%
12.4 pts worse
|
Numerator 10 · Denominator 78 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.1 |
1.6
0.5 pts better
|
1.9
0.8 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 0.7 · Expected 1.3 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.9 |
1.6
0.3 pts worse
|
1.8
0.1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 1.9 · Observed 1.4 · Expected 1.3 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.6% |
89.9%
9.7 pts better
|
93.4%
6.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 98.6% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 99.6% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
94.5%
5.5 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.5% |
3.6%
1.1 pts better
|
3.3%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.7% · Q2 4.5% · Q3 0.0% · Q4 0.0% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.4% |
11.8%
11.4 pts better
|
11.4%
11 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.4% |
| Percentage of long-stay residents who lose too much weight | 2.4% |
6.2%
3.8 pts better
|
5.4%
3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.0% · Q2 0.0% · Q3 5.7% · Q4 1.8% · 4Q avg 2.4% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 27.6% |
32.2%
4.6 pts better
|
19.6%
8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.8% · Q2 27.3% · Q3 24.1% · Q4 28.6% · 4Q avg 27.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 11.7% |
18.1%
6.4 pts better
|
16.7%
5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 12.8% · Q2 15.2% · Q3 11.5% · Q4 7.8% · 4Q avg 11.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 36.8% |
19.9%
16.9 pts worse
|
16.3%
20.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 28.4% · Q2 56.8% · Q3 12.8% · Q4 47.9% · 4Q avg 36.8% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 26.9% |
15.3%
11.6 pts worse
|
14.9%
12 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 39.6% · Q2 23.5% · Q3 18.9% · Q4 26.8% · 4Q avg 26.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.2% |
0.9%
1.3 pts worse
|
1.0%
1.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 1.5% · Q3 1.5% · Q4 2.5% · 4Q avg 2.2% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.1% |
1.9%
0.8 pts better
|
1.7%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 0.0% · Q4 2.8% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 31.1% |
20.2%
10.9 pts worse
|
19.8%
11.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 35.0% · Q2 35.2% · Q3 30.9% · Q4 24.1% · 4Q avg 31.1% |
| Percentage of long-stay residents with pressure ulcers | 1.0% |
5.4%
4.4 pts better
|
5.1%
4.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.7% · Q2 0.0% · Q3 0.0% · Q4 1.4% · 4Q avg 1.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 98.2% |
79.6%
18.6 pts better
|
81.7%
16.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 96.9% · Q2 97.1% · Q3 99.0% · Q4 100.0% · 4Q avg 98.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 16.1% |
11.2%
4.9 pts worse
|
12.0%
4.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 16.1% · Observed 15.0% · Expected 10.4% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.5% |
1.6%
1.1 pts better
|
1.6%
1.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 1.9% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 96.4% |
79.8%
16.6 pts better
|
79.7%
16.7 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 96.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 21.3% |
22.2%
0.9 pts better
|
23.9%
2.6 pts better
|
Short Stay · 20240701-20250630 · Adjusted 21.3% · Observed 20.0% · Expected 22.4% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2019-11-20 · Fire 2019-11-20
0 health deficiencies
No concentrated health issue counts in this cycle.
6 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cycle 3
Health 2018-11-28 · Fire 2018-11-28
2 health deficiencies
Top issue: Pharmacy Service (1 deficiency)
2 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-05-14
E15 · Emergency Preparedness Deficiencies
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
E37 · Emergency Preparedness Deficiencies
Fire Safety
Establish staff and initial training requirements.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K232 · Egress Deficiencies
Fire Safety
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-14
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2025-06-30
D · Potential for more than minimal harm
2019-11-20
E6 · Emergency Preparedness Deficiencies
Fire Safety
Conduct risk assessment and an All-Hazards approach.
Corrected 2019-12-31
D · Potential for more than minimal harm
2019-11-20
K232 · Egress Deficiencies
Fire Safety
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
Corrected 2019-12-31
D · Potential for more than minimal harm
2019-11-20
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2019-12-31
D · Potential for more than minimal harm
2019-11-20
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2019-12-31
D · Potential for more than minimal harm
2019-11-20
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2019-12-31
D · Potential for more than minimal harm
2019-11-20
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2019-12-31
C · Minimal harm
2018-11-28
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2018-12-28
C · Minimal harm
2018-11-28
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2018-12-05
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-05-14
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2025-06-06
D · Potential for more than minimal harm
2025-05-14
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2025-05-23
D · Potential for more than minimal harm
2025-05-14
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2025-05-23
D · Potential for more than minimal harm
2018-11-28
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2018-12-28
D · Potential for more than minimal harm
2018-11-28
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2018-12-28
Penalties and ownership
What sits behind the stars
Ownership
Overton County Ambulance Service
5% Or Greater Direct Ownership Interest · Organization
Boswell, Randall
Corporate Officer · Individual
Bouldin, Jennifer
W-2 Managing Employee · Individual
Clark, Darwin
Corporate Officer · Individual
Melton, Robbie
Corporate Officer · Individual
Savage, Donna
Corporate Officer · Individual
Zalewski, Charla
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Celina Health And Rehabilitation Center
Celina, TN
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#2
Signature Healthcare Of Putnam County
Cookeville, TN
2-star overall rating with 2-star inspections with 13 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
#3
Standing Stone Care And Rehab
Monterey, TN
4-star overall rating with 4-star inspections with 3 recent health deficiencies with 16 fire-safety deficiencies in the latest cycle
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