Signature Healthcare of Putnam County
Cookeville, Tennessee
Skilled nursing facility in Cookeville, TN with 175 certified beds and a 2-star CMS overall rating.
Signature Healthcare of Putnam County is a skilled nursing facility in Cookeville, Tennessee (Putnam County), with 175 Medicare/Medicaid-certified beds.
Address: 278 Dry Valley Rd, Cookeville, TN 38506. Phone: (931) 537-6524.
Ownership: For profit - Limited Liability company. Certified for Medicare and Medicaid. Automatic sprinkler systems in all required areas. Has a resident council. Part of the Signature Healthcare chain.
CMS Five-Star ratings (source: Medicare Care Compare): overall 2 of 5, health inspections 2, staffing 2, quality measures 4.
Levels of care
- Skilled nursing
Facility details
- Street address
- 278 Dry Valley Rd
- City
- Cookeville
- State
- Tennessee
- ZIP code
- 38506
- Phone
- (931) 537-6524
- Levels of care
- Skilled nursing
- Payment options accepted
- Medicare, Medicaid
- Cms Ccn
- 445136
- County
- Putnam
- Ownership Type
- For profit - Limited Liability company
- Provider Type
- Medicare and Medicaid
- Certified Beds
- 175
- Avg Daily Residents
- 139.4
- Continuing Care Community
- No
- Resident Family Council
- Resident
- Sprinklers All Areas
- Yes
- Medicare Medicaid Approved Date
- 1980-09-29
- Chain Name
- Signature Healthcare
- Overall Rating
- 2
- Health Inspection Rating
- 2
- Staffing Rating
- 2
- Quality Measure Rating
- 4
- Total Nurse Hours Per Resident Day
- 3.66537
- Rn Hours Per Resident Day
- 0.47573
- Latitude
- 36.1856
- Longitude
- -85.451
Medicare & Medicaid quality data
Published by the Centers for Medicare & Medicaid Services (CMS) [1] , data as of October 1, 2026. CMS ID 445136. Ratings compare this home with other nursing homes; they are not a pass or fail.
How does it compare in Cookeville? · Lowest-rated in Tennessee
CMS overall rating
2 / 5
Below average- Certified beds
- 175
- Residents per day
- 133
- Ownership
- For profit - Limited Liability company
- Health citations (latest)
- 2
- Fines
- 0
Star ratings
CMS rates every certified nursing home from 1 to 5 stars in three areas and combines them into an overall rating. The ratings compare homes with each other: 5 is much above average, 3 is average, 1 is much below average.
Overall rating
Below averageThe headline score, from 1 to 5 stars.
✗ Worse than the state average. State 3.1 · National 3.0
How is this scored?
Three steps: start with the health inspection stars; add one star if staffing is 5 stars (subtract one if it is 1 star); then add one star if quality measures are 5 stars (subtract one if 1 star). It never goes above 5 or below 1, and a home with 1 health inspection star can gain at most one star from the other two. It compares homes with each other; it is not a pass/fail grade. [11]
Health inspections
Below averageHow the home did in recent state inspections and complaint investigations.
✗ Worse than the state average. State 3.0 · National 2.8
How is this scored?
Based on the two most recent annual inspections plus 36 months of complaint and infection-control inspections, and on how many revisits were needed to confirm fixes. Each citation is weighted by scope and severity. Homes are then ranked within their own state: the best 10% (lowest scores) earn 5 stars, the middle 70% earn 2, 3 or 4 stars in equal shares, and the worst 20% earn 1 star. [11]
Staffing
Below averageHow many nurses care for each resident, and how stable the nursing team is.
✗ Worse than the state average. State 2.5 · National 3.0
How is this scored?
Six measures: three of staffing level (total nurse, registered nurse and weekend nurse hours per resident per day, adjusted for how much care residents need) and three of turnover (nursing staff, RNs and administrators). The hours come from payroll records submitted to CMS each quarter; turnover uses six quarters of that data. [11]
Quality measures
Above averageHow residents are actually doing.
✓ Better than the state average. State 3.7 · National 3.7
How is this scored?
Scores 15 quality measures drawn from resident assessments (the Minimum Data Set) and Medicare claims, such as falls with major injury, pressure ulcers, rehospitalizations and medication use. Long-stay and short-stay residents are rated separately and combined. [11]
This home State average National average
- Long-stay quality
- Residents who live in the home: outcomes such as falls, pressure ulcers and medication use.
- Short-stay quality
- Residents staying for rehab or recovery: outcomes such as rehospitalization and regaining function.
How to read the numbers on this page
- Star ratings — 1 to 5 (no stars = not rated)
- 5 is much above average and 1 is much below average, compared with other nursing homes. A home with too little data may have no rating.
- Health inspection score — 0 and up, lower is better
- Points added up from citations (see the scope and severity grid) and revisits. 0 means a clean record; the state table shows which scores earn which stars.
- Quality measure percentages — 0 to 100%
- The share of residents with an outcome, such as a fall with major injury. For most measures a lower percentage is better; for vaccination measures a higher percentage is better.
- Nurse hours per resident per day — Hours, higher is better
- Paid nursing time divided by residents. For example 4.0 means each resident gets about four hours of nursing care a day, shared across all shifts.
- Staff turnover — 0 to 100%, lower is better
- The share of nursing staff who left during the year. High turnover can mean less continuity of care.
- Case-mix index — Around 1.0 is typical
- How much care the residents need. Above 1 means sicker or more dependent residents who need more staff time.
- Fines — Dollars; payment denials in days
- Penalties CMS imposed for serious or repeated problems. A payment denial stops Medicare/Medicaid payment for new admissions.
Sources: Nursing Home Provider Information [1] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Staffing & turnover
More nursing time per resident and a steadier team are both signs of better care. Hours come from payroll records the home submits to CMS each quarter.
Nurse hours per resident per day, by role
A resident's day is 24 hours; this is how much paid nursing time each resident gets, shared across all shifts.
RN 0.47 · LPN 1.00 · Nurse aide 2.22. What the home's payroll records show.
RN 0.78 · LPN 0.98 · Nurse aide 2.66. What CMS predicts a home with these residents' needs would staff.
RN 0.42 · LPN 0.88 · Nurse aide 1.94. The reported hours rescaled so homes with sicker or healthier residents can be compared fairly.
Compared with TN and the nation
This home State average National average
- Total nurse hours (hrs/resident/day, higher is better)
- 3.69
✗ Worse than the state average. State 3.82 · National 3.90
- Registered nurse (RN) hours (hrs/resident/day, higher is better)
- 0.47
✗ Worse than the state average. State 0.60 · National 0.69
- Licensed nurse hours (RN + LPN) (hrs/resident/day, higher is better)
- 1.47
✗ Worse than the state average. State 1.68 · National 1.55
- Nurse aide hours (hrs/resident/day, higher is better)
- 2.22
✓ Better than the state average. State 2.14 · National 2.35
- Weekend total nurse hours (hrs/resident/day, higher is better)
- 3.00
✗ Worse than the state average. State 3.32 · National 3.43
- Weekend RN hours (hrs/resident/day, higher is better)
- 0.28
✗ Worse than the state average. State 0.39 · National 0.48
- Physical therapist hours (hrs/resident/day, higher is better)
- 0.10
✓ Better than the state average. State 0.08 · National 0.07
- Nursing staff turnover (%, lower is better)
- 40.0%
✓ Better than the state average. State 48.6% · National 45.3%
- RN turnover (%, lower is better)
- 47.1%
✗ Worse than the state average. State 43.2% · National 42.5%
- Administrators who left (people, lower is better)
- 0
✓ Better than the state average. State 1 · National 1
- Nursing case-mix index (index)
- 1.60
State 1.48 · National 1.41
Turnover is the share of nursing staff who left over the year. The case-mix index shows how much care residents need: about 1.0 is typical, higher means more dependent residents.
Sources: Nursing Home Provider Information [1] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Inspections
State inspectors visit each home about once a year and investigate complaints. Every problem they cite is a deficiency, lettered A to L by how serious and how widespread it was.
Health inspection score
33.0 points — in TN that earns (Below average).
Lower is better. The score adds up points for every citation (more for serious, widespread problems) and for revisits needed to confirm fixes, then weights recent inspections most. [11]
Score needed for each star in TN [10]
- 5 ★
- 0.000-9.000
- 4 ★
- 9.001-17.000
- 3 ★
- 17.001-31.000
- 2 ★ (this home)
- 31.001-61.000
- 1 ★
- >61.000
| Period | Inspection | Citations (complaint) | Citation points | Revisits | Revisit points | Total |
|---|---|---|---|---|---|---|
| Most recent cycle | Jul 22, 2026 | 2 (0) | 8 | 1 | 0 | 8 |
| Prior cycles (2 and 3) | May 18, 2023 | 13 (3) | 108 | 1 | 0 | 108 |
Health citations per inspection
Jul 22, 2026
May 18, 2023
Apr 10, 2019
State average for that cycle. Fewer is better.
Fire-safety citations per inspection
Jul 22, 2026
May 18, 2023
Apr 10, 2019
State average for that cycle. Fewer is better.
What the latest health inspection cited
- Freedom from Abuse and Neglect and Exploitation 1
- Quality of Life and Care 1
What the latest fire-safety inspection cited
- Smoke 1
How serious were the citations?
Each health citation gets a letter. The number in each cell is how many of this home's citations got that letter; the points show what each letter adds to the health inspection score. Citations where care was substandard score higher than shown. [11]
| Isolated (a few residents) | Pattern (some residents) | Widespread (many residents) | |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | J · 50 pts 0 | K · 100 pts 0 | L · 150 pts 0 |
| Actual harm, not immediate jeopardy | G · 20 pts 0 | H · 35 pts 0 | I · 45 pts 0 |
| No actual harm, potential for more than minimal harm | D · 4 pts 9 | E · 8 pts 2 | F · 16 pts 4 |
| No actual harm, potential for minimal harm only | A · 0 pts 0 | B · 0 pts 0 | C · 0 pts 0 |
Darker cells mean more citations. Counts cover every health citation CMS lists for this home.
All health citations (15) [2]
Inspection on Jul 22, 2026 · 2 citations
-
D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
F0609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction (Jul 31, 2026)
-
D
Provide safe and appropriate respiratory care for a resident when needed.
F0695 · Quality of Life and Care Deficiencies · Deficient, Provider has date of correction (Jul 31, 2026)
Inspection on Apr 3, 2025 · 3 citations
-
D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F0689 · Quality of Life and Care Deficiencies · Deficient, Provider has date of correction (Apr 16, 2025) · From a complaint
-
D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
F0657 · Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction (Apr 16, 2025) · From a complaint
-
D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F0755 · Pharmacy Service Deficiencies · Past Non-Compliance (Sep 6, 2024) · From a complaint
Inspection on May 18, 2023 · 10 citations
-
F
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F0804 · Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
F0657 · Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
D
Provide safe and appropriate respiratory care for a resident when needed.
F0695 · Quality of Life and Care Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
F
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
F0802 · Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
F0684 · Quality of Life and Care Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
F0725 · Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F0812 · Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
E
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.
F0584 · Resident Rights Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F0550 · Resident Rights Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
-
D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F0689 · Quality of Life and Care Deficiencies · Deficient, Provider has date of correction (Jul 2, 2023)
All fire-safety citations (3) [3]
Inspection on Jul 22, 2026 · 1 citation
-
D
Provide properly protected cooking facilities.
K0324 · Smoke Deficiencies · Deficient, Provider has date of correction (Jul 31, 2026)
Inspection on May 18, 2023 · 1 citation
-
D
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.
K0222 · Egress Deficiencies · Deficient, Provider has date of correction (Jun 27, 2023)
Inspection on Apr 10, 2019 · 1 citation
-
D
Meet requirements for the installation and maintenance of electrical systems.
K0911 · Gas, Vacuum, and Electrical Systems Deficiencies · Deficient, Provider has date of correction (May 3, 2019)
Sources: Nursing Home Provider Information [1] ; Nursing Home Survey Summary [4] ; Nursing Home Health Deficiencies [2] ; Nursing Home Fire Safety Deficiencies [3] ; Nursing Home Health Inspection Cut Points [10] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Fines & penalties
CMS can fine a home or stop Medicare and Medicaid payments for new admissions when problems are serious or keep recurring. Most homes have none.
- Fines
- 0 State avg 0.5 · National 0.9
- Total fined
- $0 State avg 20,665 · National 30,351
- Payment denials
- 0 Periods with no Medicare/Medicaid payment for new admissions
Sources: Nursing Home Provider Information [1] ; Nursing Home Penalties [5] ; Nursing Home State & National Averages [9]
Resident quality measures
These measure what actually happens to residents, as a percentage from 0 to 100 (or events per 1,000 resident days). For almost all of them a lower number is better; the vaccination measures are the exception and are marked. A star means the measure counts toward the quality star rating.
This home State average National average
Long-stay residents (14) [7]
Residents who live in the home. From their regular health assessments (the Minimum Data Set), averaged over four quarters. Period: 2025Q3-2026Q2.
- Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Higher is better
- 96.2
✓ Better than the state average. State 89.5 · National 93.7
- Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Higher is better
- 96.8
✓ Better than the state average. State 93.8 · National 95.3
- Percentage of long-stay residents experiencing one or more falls with major injury ★ Lower is better
- 2.2
✓ Better than the state average. State 3.3 · National 3.2
- Percentage of long-stay residents who have depressive symptoms Lower is better
- 13.9
✓ Better than the state average. State 14.9 · National 13.5
- Percentage of long-stay residents who lose too much weight Lower is better
- 10.9
✗ Worse than the state average. State 6.0 · National 5.1
- Percentage of long-stay residents who received an antianxiety or hypnotic medication Lower is better
- 16.0
✓ Better than the state average. State 31.7 · National 19.5
- Percentage of long-stay residents who received an antipsychotic medication ★ Lower is better
- 20.4
✗ Worse than the state average. State 17.0 · National 15.4
- Percentage of long-stay residents who were physically restrained Lower is better
- 0.0
✓ Better than the state average. State 0.1 · National 0.1
- Percentage of long-stay residents whose ability to walk independently worsened ★ Lower is better
- 10.2
✓ Better than the state average. State 15.4 · National 12.7
- Percentage of long-stay residents whose need for help with daily activities has increased ★ Lower is better
- 9.4
✓ Better than the state average. State 13.5 · National 13.5
- Percentage of long-stay residents with a catheter inserted and left in their bladder ★ Lower is better
- 0.6
≈ About the state average. State 0.6 · National 0.7
- Percentage of long-stay residents with a urinary tract infection ★ Lower is better
- 0.9
✓ Better than the state average. State 1.7 · National 1.5
- Percentage of long-stay residents with new or worsened bowel or bladder incontinence Lower is better
- 16.3
✓ Better than the state average. State 19.0 · National 18.3
- Percentage of long-stay residents with pressure ulcers ★ Lower is better
- 5.2
✗ Worse than the state average. State 4.8 · National 4.5
Short-stay residents (3) [7]
Residents staying for rehab or recovery. From their health assessments, averaged over four quarters. Period: 2025Q3-2026Q2.
- Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Higher is better
- 83.0
✓ Better than the state average. State 79.4 · National 82.3
- Percentage of short-stay residents who newly received an antipsychotic medication ★ Lower is better
- 0.7
✓ Better than the state average. State 1.7 · National 1.5
- Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Higher is better
- 80.4
≈ About the state average. State 79.2 · National 80.1
Long-stay residents: hospital use (2) [8]
Hospital stays and emergency visits found in Medicare claims, adjusted for how sick residents were. Period: 20250401-20260331.
- Number of hospitalizations per 1000 long-stay resident days ★ Lower is better · Expected for these residents: 1.8
- 1.7
✗ Worse than the state average. State 1.6 · National 1.8
- Number of outpatient emergency department visits per 1000 long-stay resident days ★ Lower is better · Expected for these residents: 1.6
- 0.4
✓ Better than the state average. State 1.5 · National 1.7
Short-stay residents: hospital use (2) [8]
Rehospitalizations and emergency visits after admission, found in Medicare claims and adjusted for how sick residents were. Period: 20250401-20260331.
- Percentage of short-stay residents who had an outpatient emergency department visit ★ Lower is better · Expected for these residents: 11.6
- 8.6
✓ Better than the state average. State 11.3 · National 11.8
- Percentage of short-stay residents who were rehospitalized after a nursing home admission ★ Lower is better · Expected for these residents: 26.0
- 25.7
✗ Worse than the state average. State 22.6 · National 23.4
Sources: Nursing Home MDS Quality Measures [7] ; Nursing Home Medicare Claims Quality Measures [8] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Ownership & operator
Who owns and runs a home can matter: for-profit, non-profit and chain-owned homes tend to differ on staffing and inspection results.
- Ownership type
- For profit - Limited Liability company
- Legal business name
- LP COOKEVILLE LLC
- Certified for
- Medicare and Medicaid
- Certified beds
- 175
- Residents per day (average)
- 133
- In Medicare/Medicaid since
- Sep 29, 1980
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
- County
- Putnam
- Located in a hospital
- No
Company profiles: Signature Healthcare (67 homes, average 3.1 stars), Jjla LLC (64 homes, average 3.1 stars), Wheaten LLC (63 homes, average 3.2 stars), Lpsnf LLC (36 homes, average 2.9 stars), Asbr Holdings LLC (31 homes, average 2.9 stars), Shc LP Holdings LLC (29 homes, average 3.1 stars)
Part of SIGNATURE HEALTHCARE
One of 67 homes in this chain. Average star ratings across the chain (1 to 5):
- Overall
- 3.1
- Health inspections
- 2.8
- Staffing
- 3.0
- Quality
- 3.9
Owners, officers and managers (8) [6]
5% Or Greater Indirect Ownership Interest
- ASBR HOLDINGS LLC (organization, since 05/01/2018)
- JJLA LLC (organization, since 05/01/2014)
- LPSNF LLC (organization, since 05/01/2014)
- STEIER III, ELMER (individual, since 05/01/2014)
- WHEATEN LLC (organization, since 05/01/2014)
W-2 Managing Employee
- BOONE, PAULA (individual, NOT APPLICABLE, since 01/16/2023)
Corporate Officer
- HARRISON, JOHN (individual, NOT APPLICABLE, since 05/01/2014)
5% Or Greater Direct Ownership Interest
- SHC LP HOLDINGS LLC (organization, 100%, since 05/01/2014)
Sources: Nursing Home Provider Information [1] ; Nursing Home Ownership [6]
Sources
All figures on this page come from the U.S. government's published nursing home data, as of October 1, 2026. We reproduce them without change except for rounding and layout; ratings, scores and flags are CMS's, not ours. Averages and comparisons use the state and national figures CMS publishes in the same release.
- 1. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Provider Information. Star ratings, staffing, turnover, inspection scores, fines, chain and flag data. https://data.cms.gov/provider-data/dataset/4pq5-n9py
- 2. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Health Deficiencies. Each health deficiency cited, with scope and severity. https://data.cms.gov/provider-data/dataset/r5ix-sfxw
- 3. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Fire Safety Deficiencies. Each fire-safety deficiency cited. https://data.cms.gov/provider-data/dataset/ifjz-ge4w
- 4. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Survey Summary. Deficiency totals by inspection cycle and category. https://data.cms.gov/provider-data/dataset/tbry-pc2d
- 5. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Penalties. Fines and payment denials. https://data.cms.gov/provider-data/dataset/g6vv-u9sr
- 6. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Ownership. Owners, officers, directors and managers. https://data.cms.gov/provider-data/dataset/y2hd-n93e
- 7. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home MDS Quality Measures. Quarterly quality measure scores from resident assessments. https://data.cms.gov/provider-data/dataset/djen-97ju
- 8. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Medicare Claims Quality Measures. Risk-adjusted quality measures from Medicare claims. https://data.cms.gov/provider-data/dataset/ijh5-nb2v
- 9. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home State & National Averages. State and national averages used for comparison. https://data.cms.gov/provider-data/dataset/xcdc-v8bm
- 10. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Health Inspection Cut Points. Score ranges that earn each health inspection star in a state. https://data.cms.gov/provider-data/dataset/hicp-9999
- 11. Centers for Medicare & Medicaid Services. Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide. How the star ratings, scope and severity points, and abuse and Special Focus flags are defined. https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/usersguide.pdf
- 12. Centers for Medicare & Medicaid Services. Medicare Care Compare. CMS's own consumer site, with the latest figures. https://www.medicare.gov/care-compare/
Attendant Homes is not affiliated with or endorsed by CMS. The data describes past inspections and reported figures and can be out of date or contain errors; it is not a recommendation. Confirm current information with the facility and on Medicare Care Compare [12] .
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