Cycle 1
Health 2023-05-18 · Fire 2023-05-18
13 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
1 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Cookeville, TN
Signature Healthcare Of Putnam County
2-star overall rating with 2-star inspections with 13 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
278 Dry Valley Rd, Cookeville, TN
(931) 537-6524
Overall
2 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
175
Certified beds
Average residents
137
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Signature Healthcare
Operator or chain grouping
Approved since
1980-09-29
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
0.45
Registered nurse staffing · state 0.61 · national 0.68
LPN hours / resident day
1.06
Licensed practical nurse staffing · state 1.09 · national 0.87
Aide hours / resident day
2.04
Nurse aide staffing · state 2.15 · national 2.35
Total nurse hours
3.54
All reported nurse hours · state 3.85 · national 3.89
Licensed hours
1.51
RN + LPN hours · state 1.70 · national 1.54
Weekend hours
2.99
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.21
Weekend registered nurse coverage · state 0.40 · national 0.47
Physical therapist
0.10
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.40
CMS adjusted RN staffing hours
Adjusted total hours
3.12
CMS adjusted total nurse staffing hours
Case-mix index
1.55
Higher values indicate more complex resident acuity
RN turnover
33%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
49%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
11,153
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
17.86
Composite VBP score used to determine payment impact.
Payment multiplier
0.9819
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.15
Baseline 18.13% · Performance 19.97% · Measure score 3.15 · Achievement 3.15 · Improvement 0
Healthcare-associated infections
0
Baseline 7.20% · Performance 8.74% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
3.99
Baseline 44.86% · Performance 47.37% · Measure score 3.99 · Achievement 3.99 · Improvement 0
Adjusted total nurse staffing
0
Baseline 3.29 hours · Performance 3.17 hours · Measure score 0 · Achievement 0 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 13.62% |
10.72%
2.9 pts worse
|
Worse than the National Rate · Eligible stays 280 · Observed rate 16.43% · Lower 95% interval 11.12% |
| Discharge to community | 48.05% |
50.57%
2.5 pts worse
|
No Different than the National Rate · Eligible stays 293 · Observed rate 37.88% · Lower 95% interval 42.53% |
| Medicare spending per beneficiary | 1.09 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 89.44% |
95.27%
5.8 pts worse
|
Numerator 144 · Denominator 161 |
| Falls with major injury | 0.62% |
0.77%
0.2 pts better
|
Numerator 1 · Denominator 161 |
| Discharge self-care score | 52.08% |
53.69%
1.6 pts worse
|
Numerator 50 · Denominator 96 |
| Discharge mobility score | 50% |
50.94%
0.9 pts worse
|
Numerator 48 · Denominator 96 |
| Pressure ulcers or injuries, new or worsened | 1.88% |
2.29%
0.4 pts better
|
Numerator 3 · Denominator 160 · Adjusted rate 1.49% |
| Healthcare-associated infections requiring hospitalization | 8.74% |
7.12%
1.6 pts worse
|
No Different than the National Rate · Eligible stays 159 · Observed rate 10.06% · Lower 95% interval 6.31% |
| Staff COVID-19 vaccination coverage | 0.85% |
8.2%
7.3 pts worse
|
Numerator 1 · Denominator 117 |
| Staff flu vaccination coverage | 31.58% |
42%
10.4 pts worse
|
Numerator 66 · Denominator 209 |
| Discharge function score | 55.21% |
56.45%
1.2 pts worse
|
Numerator 53 · Denominator 96 |
| Transfer of health information to provider | 97.27% |
95.95%
1.3 pts better
|
Numerator 107 · Denominator 110 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 38.37% |
25.2%
13.2 pts better
|
Numerator 33 · Denominator 86 |
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 1.1 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.4 |
1.6
1.2 pts better
|
1.8
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.4 · Observed 0.4 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 95.4% |
89.9%
5.5 pts better
|
93.4%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 90.3% · Q2 95.7% · Q3 100.0% · Q4 95.6% · 4Q avg 95.4% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 95.9% |
94.5%
1.4 pts better
|
95.5%
0.4 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 95.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.6% |
3.6%
1 pts better
|
3.3%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.5% · Q2 1.7% · Q3 2.6% · Q4 2.7% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 2.2% |
11.8%
9.6 pts better
|
11.4%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.0% · Q2 1.9% · Q3 1.0% · Q4 3.9% · 4Q avg 2.2% |
| Percentage of long-stay residents who lose too much weight | 6.0% |
6.2%
0.2 pts better
|
5.4%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.7% · Q2 9.1% · Q3 3.7% · Q4 5.5% · 4Q avg 6.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 17.5% |
32.2%
14.7 pts better
|
19.6%
2.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 21.3% · Q2 17.1% · Q3 14.4% · Q4 17.3% · 4Q avg 17.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 20.4% |
18.1%
2.3 pts worse
|
16.7%
3.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.0% · Q2 23.1% · Q3 19.1% · Q4 19.6% · 4Q avg 20.4% · 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 | 19.9% |
19.9%
About the same
|
16.3%
3.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 17.7% · Q2 10.7% · Q3 31.8% · Q4 18.7% · 4Q avg 19.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.9% |
15.3%
0.6 pts worse
|
14.9%
1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.5% · Q2 13.3% · Q3 19.4% · Q4 14.6% · 4Q avg 15.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.9% |
0.9%
About the same
|
1.0%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.7% · Q2 1.2% · Q3 0.0% · Q4 0.6% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.2% |
1.9%
0.3 pts worse
|
1.7%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 2.6% · Q3 2.6% · Q4 1.8% · 4Q avg 2.2% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 16.1% |
20.2%
4.1 pts better
|
19.8%
3.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 18.1% · Q2 19.4% · Q3 11.9% · Q4 15.2% · 4Q avg 16.1% |
| Percentage of long-stay residents with pressure ulcers | 5.1% |
5.4%
0.3 pts better
|
5.1%
About the same
|
Long Stay · 2024Q4-2025Q3 · Q1 6.6% · Q2 4.9% · Q3 4.1% · Q4 4.9% · 4Q avg 5.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 86.7% |
79.6%
7.1 pts better
|
81.7%
5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 86.0% · Q2 88.4% · Q3 85.4% · Q4 86.9% · 4Q avg 86.7% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 5.4% |
11.2%
5.8 pts better
|
12.0%
6.6 pts better
|
Short Stay · 20240701-20250630 · Adjusted 5.4% · Observed 5.5% · Expected 11.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.7% |
1.6%
0.9 pts better
|
1.6%
0.9 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.9% · Q2 0.0% · Q3 0.9% · Q4 1.0% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 86.9% |
79.8%
7.1 pts better
|
79.7%
7.2 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 86.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 23.0% |
22.2%
0.8 pts worse
|
23.9%
0.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 23.0% · Observed 24.4% · Expected 25.2% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2019-04-10 · Fire 2019-04-10
0 health deficiencies
No concentrated health issue counts in this cycle.
1 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Cycle 3
Health 2018-04-25 · Fire 2018-04-25
1 health deficiencies
Top issue: Resident Assessment and Care Planning (1 deficiency)
4 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2023-05-18
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2023-06-27
D · Potential for more than minimal harm
2019-04-10
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2019-05-03
D · Potential for more than minimal harm
2018-04-25
K908 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure gas and vacuum systems are inspected and tested as part of a maintenance program.
Corrected 2018-05-10
C · Minimal harm
2018-04-25
E22 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for sheltering.
Corrected 2018-05-11
C · Minimal harm
2018-04-25
E24 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for volunteers.
Corrected 2018-05-11
C · Minimal harm
2018-04-25
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2018-05-11
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-04-03
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2025-04-16
D · Potential for more than minimal harm
2025-04-03
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 2025-04-16
D · Potential for more than minimal harm
2025-04-03
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-09-06
F · Potential for more than minimal harm
2023-05-18
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 2023-07-02
F · Potential for more than minimal harm
2023-05-18
F802 · Nutrition and Dietary Deficiencies
Health
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Corrected 2023-07-02
F · Potential for more than minimal harm
2023-05-18
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2023-07-02
F · Potential for more than minimal harm
2023-05-18
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 2023-07-02
E · Potential for more than minimal harm
2023-05-18
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-07-02
E · Potential for more than minimal harm
2023-05-18
F584 · Resident Rights Deficiencies
Health
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.
Corrected 2023-07-02
D · Potential for more than minimal harm
2023-05-18
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-07-02
D · Potential for more than minimal harm
2023-05-18
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-07-02
D · Potential for more than minimal harm
2023-05-18
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 2023-07-02
D · Potential for more than minimal harm
2023-05-18
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-07-02
D · Potential for more than minimal harm
2018-04-25
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2018-05-04
Penalties and ownership
What sits behind the stars
Ownership
Shc LP Holdings LLC
5% Or Greater Direct Ownership Interest · Organization
Asbr Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Boone, Paula
W-2 Managing Employee · Individual
Harrison, John
Corporate Officer · Individual
Jjla LLC
5% Or Greater Indirect Ownership Interest · Organization
Lpsnf LLC
5% Or Greater Indirect Ownership Interest · Organization
Smedra, Ira
5% Or Greater Indirect Ownership Interest · Individual
Steier Iii, Elmer
5% Or Greater Indirect Ownership Interest · Individual
Wheaten LLC
5% Or Greater Indirect Ownership Interest · Organization
Nearby options
Other facilities in reach
#1
Ahc Bethesda
Cookeville, TN
2-star overall rating with 2-star inspections with 6 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
#2
Nhc Healthcare, Cookeville
Cookeville, TN
5-star overall rating with 4-star inspections with 3 recent health deficiencies
#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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