Annville, KY

Signature Healthcare at Jackson Manor Rehab and We

2-star overall rating with 3-star inspections with 2 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

96 Highway 3444, Annville, KY

(606) 364-5197

Compare this facility

Overall

2 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

1 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

51

Certified beds

Average residents

47

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Signature Healthcare

Operator or chain grouping

Approved since

1991-03-12

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

71 facilities

Chain averages 3 overall / 3 health / 3 staffing / 4 quality stars

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

1.30

Registered nurse staffing · state 0.77 · national 0.68

LPN hours / resident day

0.31

Licensed practical nurse staffing · state 0.81 · national 0.87

Aide hours / resident day

2.16

Nurse aide staffing · state 2.43 · national 2.35

Total nurse hours

3.77

All reported nurse hours · state 4.01 · national 3.89

Licensed hours

1.61

RN + LPN hours · state 1.58 · national 1.54

Weekend hours

3.08

Weekend nurse staffing · state 3.50 · national 3.43

Weekend RN hours

0.70

Weekend registered nurse coverage · state 0.52 · national 0.47

Physical therapist

0.13

Reported PT staffing · state 0.06 · national 0.07

Adjusted RN hours

1.02

CMS adjusted RN staffing hours

Adjusted total hours

2.96

CMS adjusted total nurse staffing hours

Case-mix index

1.74

Higher values indicate more complex resident acuity

RN turnover

79%

Annual RN turnover · state 43% · national 45%

Total nurse turnover

74%

Annual nurse turnover · state 47% · national 46%

SNF VBP

Value-based purchasing

Program rank

11,888

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

14.85

Composite VBP score used to determine payment impact.

Payment multiplier

0.9814

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Healthcare-associated infections

3.18

Baseline 7.03% · Performance 6.88% · Measure score 3.18 · Achievement 3.18 · Improvement 0.23

Total nurse turnover

0

Baseline 31.71% · Performance 64.41% · Measure score 0 · Achievement 0 · Improvement 0

Adjusted total nurse staffing

1.28

Baseline 3.63 hours · Performance 3.44 hours · Measure score 1.28 · Achievement 1.28 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	12.17%	10.72% 1.4 pts worse	No Different than the National Rate · Eligible stays 63 · Observed rate 17.46% · Lower 95% interval 8.06%
Discharge to community	57.99%	50.57% 7.4 pts better	No Different than the National Rate · Eligible stays 55 · Observed rate 50.91% · Lower 95% interval 43.77%
Medicare spending per beneficiary	0.85	1.02 0.2 pts better
Drug regimen review with follow-up	68.18%	95.27% 27.1 pts worse	Numerator 15 · Denominator 22
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 22
Discharge self-care score	Not Available	53.69%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.
Discharge mobility score	Not Available	50.94%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.
Pressure ulcers or injuries, new or worsened	0%	2.29% 2.3 pts better	Numerator 0 · Denominator 22 · Adjusted rate 0%
Healthcare-associated infections requiring hospitalization	6.88%	7.12% 0.2 pts better	No Different than the National Rate · Eligible stays 31 · Observed rate 6.45% · Lower 95% interval 3.7%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 51
Staff flu vaccination coverage	1.02%	42% 41 pts worse	Numerator 1 · Denominator 98
Discharge function score	Not Available	56.45%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 6 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	94.9%	94.3% 0.6 pts better	93.4% 1.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 80.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 94.9%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	93.0%	96.2% 3.2 pts worse	95.5% 2.5 pts worse	Long Stay · 2024Q3-2025Q2 · 4Q avg 93.0%
Percentage of long-stay residents experiencing one or more falls with major injury	1.9%	3.8% 1.9 pts better	3.3% 1.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.5% · Q3 4.9% · Q4 0.0% · 4Q avg 1.9% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	68.3%	15.2% 53.1 pts worse	11.4% 56.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 44.4% · Q2 55.2% · Q3 79.4% · Q4 87.9% · 4Q avg 68.3%
Percentage of long-stay residents who lose too much weight	8.6%	6.7% 1.9 pts worse	5.4% 3.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 5.3% · Q2 5.1% · Q3 12.5% · Q4 11.4% · 4Q avg 8.6%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	54.5%	29.6% 24.9 pts worse	19.6% 34.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 59.0% · Q2 55.0% · Q3 53.7% · Q4 50.0% · 4Q avg 54.5%
Percentage of long-stay residents who received an antipsychotic medication	27.1%	17.6% 9.5 pts worse	16.7% 10.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 33.3% · Q2 34.6% · Q3 23.1% · Q4 16.0% · 4Q avg 27.1% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.2% 0.2 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	8.0%	17.3% 9.3 pts better	16.3% 8.3 pts better	Long Stay · 2024Q4-2025Q3 · 4Q avg 8.0% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	7.3%	15.6% 8.3 pts better	14.9% 7.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 17.2% · Q2 3.2% · Q3 6.1% · Q4 3.3% · 4Q avg 7.3% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.0%	0.7% 0.7 pts better	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% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.0%	1.7% 1.7 pts better	1.7% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	24.3%	19.8% 4.5 pts worse	19.8% 4.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 23.7% · Q2 36.4% · Q3 14.9% · Q4 22.6% · 4Q avg 24.3%
Percentage of long-stay residents with pressure ulcers	3.9%	5.5% 1.6 pts better	5.1% 1.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 8.4% · Q2 3.6% · Q3 3.3% · Q4 0.0% · 4Q avg 3.9% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	87.6%	83.8% 3.8 pts better	81.7% 5.9 pts better	Short Stay · 2024Q4-2025Q3 · Q1 64.0% · Q2 84.0% · Q3 100.0% · Q4 100.0% · 4Q avg 87.6%
Percentage of short-stay residents who had an outpatient emergency department visit	4.7%	13.9% 9.2 pts better	12.0% 7.3 pts better	Short Stay · 20240701-20250630 · Adjusted 4.7% · Observed 4.5% · Expected 10.8% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	3.1%	1.8% 1.3 pts worse	1.6% 1.5 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 5.6% · Q4 5.7% · 4Q avg 3.1% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	84.0%	83.6% 0.4 pts better	79.7% 4.3 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 84.0%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	43.2%	24.5% 18.7 pts worse	23.9% 19.3 pts worse	Short Stay · 20240701-20250630 · Adjusted 43.2% · Observed 40.9% · Expected 22.6% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-05-02 · Fire 2025-05-02

2 health deficiencies

Top issue: Resident Assessment and Care Planning (2 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 2 Health 2020-09-25 · Fire 2020-09-25

7 health deficiencies

Top issue: Quality of Life and Care (2 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Cycle 3 Health 2019-03-28 · Fire 2019-03-28

10 health deficiencies

Top issue: Nutrition and Dietary (3 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2025-05-02

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2025-05-21

D · Potential for more than minimal harm 2025-05-02

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 2025-05-21

D · Potential for more than minimal harm 2025-05-02

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2025-05-21

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-05-02

F640 · Resident Assessment and Care Planning Deficiencies

Health

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Corrected 2025-05-24

D · Potential for more than minimal harm 2025-05-02

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2025-05-24

D · Potential for more than minimal harm 2023-12-21

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Corrected 2024-01-15

D · Potential for more than minimal harm 2023-04-20

F559 · Resident Rights Deficiencies

Health

Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.

Corrected 2023-05-06

D · Potential for more than minimal harm 2023-04-20

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 2023-05-06

D · Potential for more than minimal harm 2023-04-20

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2023-05-06

E · Potential for more than minimal harm 2020-09-25

F725 · Nursing and Physician Services Deficiencies

Health

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Corrected 2020-10-31

E · Potential for more than minimal harm 2020-09-25

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2020-10-31