What is Life Care Center of Gray's Medicare star rating?

CMS rates Life Care Center of Gray 1 out of 5 stars overall, with 1 for health inspections, 4 for staffing and 4 for quality measures (CMS data as of September 1, 2026).

How many deficiencies did Life Care Center of Gray get at its last inspection?

6 health deficiencies at the standard inspection on September 19, 2023. The Tennessee average is 4.4.

Does Life Care Center of Gray accept Medicaid?

It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.

Who owns Life Care Center of Gray?

CMS lists 7 owners and managers, and links the home to Life Care Centers of America. Legal business name: GRAY MEDICAL INVESTORS, LLC.

Life Care Center of Gray: Inspections, Staffing & Ratings

The record in brief

At its most recent standard inspection, on September 19, 2023, inspectors cited 6 health deficiencies (the Tennessee average is 4.4, the national average 9.2).

Of 16 health citations since October 2018, 4 were rated as actual harm or immediate jeopardy to residents (4 immediate jeopardy).

CMS lists 1 fine totaling $10,039 in the last three years; the largest was $10,039, and the latest is dated April 12, 2024.

Nurses and nurse aides worked 3.40 hours per resident per day, against 3.80 across Tennessee and 3.86 nationally. Registered nurses accounted for 0.61 of those hours.

33.3% of nursing staff left within the year CMS measured (Tennessee average 48.9%).

CMS links it to Life Care Centers of America, an affiliated group of 194 nursing homes.

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

410/18

012/19

609/23

504/24

106/24

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 16 health citations on file.

Severity

Isolated

Pattern

Widespread

Immediate jeopardy

Actual harm

Potential for more than minimal harm

Potential for minimal harm

June 20, 2024Complaint inspection · 1 citation

D

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

F550 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) July 12, 2024

Inspectors wroteBased on facility policy review, medical record review, facility investigation review, and interviews the facility failed to maintain or enhance 1 resident's (Resident #4's) dignity and respect when 1 Certified Nursing Assistant (CNA) cursed in front of the resident while providing care of 11 residents observed for resident rights.

April 12, 2024Complaint inspection · 5 citations

J

Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).

F603 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 12, 2024

Inspectors wroteBased on facility policy review, medical record review, facility documentation review, observation, and interview, the facility failed to protect the resident's right to be free from involuntary seclusion for 1 of 6 (Resident #1) sampled residents reviewed for abuse/involuntary seclusion. On [DATE], Resident #1 was observed by staff to be secluded in the dining/day room of the secured unit for an unspecified amount of time. Resident #1, a vulnerable and severely cognitively impaired resident, was found in the dining/day room with the doors closed and 2 wheelchairs with their wheels locked blocking the doors when a staff member made rounds early in the morning on [DATE]. [...]
J

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

F609 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 12, 2024

Inspectors wroteBased on facility policy review, medical record review, facility documentation review, witness statement review, observation, and interview, the facility failed to report an allegation of abuse to the State Survey Agency for 1 of 6 (Resident #1) sampled residents reviewed for abuse. Resident #1, a vulnerable and severely cognitively impaired resident, was found in the dining/day room with the doors closed and 2 wheelchairs with their wheels locked blocking the doors when a staff member made rounds early on the morning of [DATE]. [...]
J

Respond appropriately to all alleged violations.

F610 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 12, 2024

Inspectors wroteBased on facility policy review, medical record review, facility documentation review, witness statement review, observation, and interview, the facility failed to thoroughly investigate an allegation of abuse for 1 of 6 (Resident #1) sampled residents reviewed for abuse. On [DATE], a staff member observed Resident #1 barricaded in the dining/day room of the secured unit for an undetermined amount of time with wheelchairs blocking the doors. Resident #1, a vulnerable and severely cognitively impaired resident, was found in the dining/day room with the doors closed and 2 wheelchairs with their wheels locked blocking the doors when a staff member made rounds early in the morning on [DATE]. [...]
J

Honor each resident's preferences, choices, values and beliefs.

F675 · Quality of Life and Care · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 12, 2024

Inspectors wroteBased on facility policy review, medical record review, facility documentation review, witness statements, observation, and interview, the facility failed to provide an environment which enhanced the resident's quality of life. The facility's failure to provide an environment for quality of life resulted in 1 resident (Resident #1) of 6 sampled residents being secluded in the dining/day room area of the secured unit for an unspecified amount of time on [DATE]. Resident #1, a vulnerable and severely cognitively impaired resident, was found in the dining/day room with the doors closed and 2 wheelchairs with their wheels locked blocking the doors when a staff member made rounds early in the morning on [DATE]. [...]
D

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) May 12, 2024

Inspectors wroteBased on review of facility policy review, medical record review, facility documentation review, witness statement review, observation, and interviews, the facility failed to implement a behavioral and wandering care plan. The facility's failure to implement a behavioral and wandering care plan resulted in 1 of 6 (Resident #1) sampled residents being secluded in the dining/day room area of the secured unit for an unspecified amount of time.

September 19, 2023Standard inspection, Complaint inspection · 6 citations

F

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

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, observations, and interview the facility failed to maintain sanitary kitchen equipment, failed to maintain a sanitary kitchen environment as evidenced by undated and unsealed food observed in 1 of 1 walk-in freezer and 1 of 1 kitchen preparation (prep) table, failed to ensure 1 of 4 kitchen staff wore protective beard coverings while preparing food, which had the potential to affect 70 of 70 residents.
D

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.

F584 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, observations, and interviews, the facility failed to maintain a safe, comfortable, and homelike environment for 4 residents (Residents #21, #38, #56 and #270) of 28 residents reviewed on the secure unit.
D

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

F644 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, medical record review and interview, the facility failed to make a referral, to the state-designated authority, for a Level II Pre-admission Screening and Resident Review (PASARR) after a newly identified mental health disorder was diagnosed for 1 resident (Resident #59) of 24 residents reviewed for PASARR.
D

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.

F758 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to ensure informed consent for use of Psychotropic medication was obtained prior to administration for 1 resident (Resident #120) of 6 residents reviewed for unnecessary medications.
D

Dispose of garbage and refuse properly.

F814 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, observation and interview, the facility failed to ensure garbage and refuse was properly contained in 2 of 3 dumpsters observed.
D

Provide and implement an infection prevention and control program.

F880 · Infection Control · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 3, 2023

Inspectors wroteBased on facility policy review, medical record review, observation and interview the facility failed to maintain infection control during medication administration for 1 resident (Resident #23) of 3 residents reviewed for medication administration.

December 18, 2019Standard inspection · 0 citations

October 31, 2018Standard inspection · 4 citations

E

Ensure medication error rates are not 5 percent or greater.

F759 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) December 15, 2018

Inspectors wroteBased on policy review, medical record review, observation, and interview the facility failed to ensure the medication pass error rate was below 5% effecting 4 residents (#3, #66, #131, and #132) of 9 residents observed during medication administration.
D

Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.

F646 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) December 15, 2018

Inspectors wroteBased on medical record review and interview the facility failed to notify the state mental health authority of a new serious mental illness diagnosis (SMI) for 1 resident (#35) of 34 residents reviewed.
D

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

F744 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) December 15, 2018

Inspectors wroteBased on facility policy, medical record review, and interview, the facility failed to monitor behaviors for 1 resident (#61) of 5 residents reviewed for dementia of 26 residents sampled.
C

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

F921 · Environmental · No actual harm, potential for minimal harm, widespread · Corrected (the home has a date of correction) December 15, 2018

Inspectors wroteBased on facility policy review, observation and interview the facility failed to provide a safe, sanitary, and comfortable environment for all residents on 4 of 4 halls observed in the facility.

Fire safety inspections

6 fire safety citations on file: 2 on September 19, 2023, 1 on December 18, 2019, 3 on October 31, 2018.

Every fire safety citation6 citations

D
Have properly installed electrical wiring and gas equipment.

K 511 · September 19, 2023 · Corrected (the home has a date of correction)
D
To conduct inspection, testing and maintenance of fire doors by qualified individuals.

K 761 · September 19, 2023 · Corrected (the home has a date of correction)
D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

K 321 · December 18, 2019 · Corrected (the home has a date of correction)
D
Keep aisles, corridors, and exits free of obstruction in case of emergency.

K 211 · October 31, 2018 · Corrected (the home has a date of correction)
D
Provide properly protected cooking facilities.

K 324 · October 31, 2018 · Corrected (the home has a date of correction)
D
Have generator or other power source capable of supplying service within 10 seconds.

K 918 · October 31, 2018 · Corrected (the home has a date of correction)

Fines and payment denials

Date	Penalty	Amount or length
April 12, 2024	Fine	$10,039

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

Measure	This home	Tennessee	United States
All nursing staff (RN, LPN and aides)	3.40	3.80	3.86
Registered nurses	0.61	0.60	0.69
All nursing staff on weekends	2.80	3.31	3.42
Nurse aides	1.88
Licensed practical nurses	0.91
Nursing staff turnover (share who left in a year)	33.3%	48.9%	45.8%
Registered nurse turnover	25.0%	43.2%	42.9%
Administrators who left	0

CMS expects 3.37 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.65 on weekdays and 2.80 on weekends, 23% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.11 in April to June 2025 to 3.40 in January to March 2026.

Quarter	All nursing staff	Registered nurses	Weekdays	Weekends	Contract staff share	Days with no RN hours	Residents a day
Jan to Mar 2026	3.40	0.61	3.65	2.80	0.0%	0 of 90	56
Oct to Dec 2025	3.26	0.58	3.48	2.72	0.0%	0 of 92	59
Jul to Sep 2025	3.25	0.64	3.55	2.48	0.0%	0 of 92	57
Apr to Jun 2025	3.11	0.60	3.35	2.53	0.0%	0 of 91	57
United States, Jan to Mar 2026	3.75	0.62	3.92	3.33	5.3%	0.5% of days
Tennessee, Jan to Mar 2026	3.75	0.56	3.95	3.27	4.0%	0.7% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

Measure	This home	Tennessee	US
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1	17.4	14.0	13.9
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1	0.0	0.7	0.8
Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1	2.4	1.8	1.6
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1	3.8	3.4	3.2
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1	1.5	1.7	1.6
Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1	14.5	17.2	14.1
Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1	5.7	5.0	4.6
Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1	30.8	16.9	15.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231	20.1	22.6	23.8
Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231	7.5	11.2	12.0
Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231	1.6	1.7	1.9
Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231	1.3	1.6	1.8

Owners and operators

Legal business name: GRAY MEDICAL INVESTORS, LLC. CMS links this home to Life Care Centers of America, a group of 194 nursing homes averaging 3.4 stars overall.

Name	Role	Type	Share	Since
Swanker, Richard	5% or greater direct ownership interest	Individual	25%	07/01/2006
Lee, Ashley	W-2 managing employee	Individual		05/11/2009
Cross, Cindy	Corporate officer	Individual		11/24/2004
Preston, Forrest	Corporate officer	Individual		11/24/2004
Swanker, Richard	Corporate officer	Individual		07/01/2006
Thurmond, Joan	Corporate officer	Individual		11/24/2004
Life Care Centers of America, Inc.	Operational/managerial control	Organization		03/24/2005

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 3 problems in this area, most recently on April 12, 2024: "Protect each resident from separation (from other residents, his/her room, or confinement to his/her room)."
When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on April 12, 2024: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on June 20, 2024: "Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights."
How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on April 12, 2024: "Honor each resident's preferences, choices, values and beliefs."
Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.80 hours per resident per day, below the Tennessee average of 3.31.

Other nursing homes nearby

NHC Healthcare, Johnson City
Johnson City, 4.3 mi · 5 of 5 stars · 1 citation
Greystone Health Care Center
Blountville, 5.2 mi · 1 of 5 stars · 31 citations
The Waters of Johnson City, LLC
Johnson City, 5.3 mi · 2 of 5 stars · 12 citations
Princeton Transitional Care & Assisted Living
Johnson City, 5.3 mi · 5 of 5 stars · 3 citations
Agape Rehabilitation & Nursing Center, a Waters Cm
Johnson City, 5.7 mi · 4 of 5 stars · 7 citations
Abundant Christian Living Community Rehabilitation
Johnson City, 5.8 mi · 5 of 5 stars · 6 citations
Lakebridge, a Waters Community, LLC
Johnson City, 7.1 mi · 3 of 5 stars · 7 citations
Four Oaks Health Care Center
Jonesborough, 8.4 mi · 4 of 5 stars · 10 citations

Tennessee contacts for a concern about a nursing home

These are the official offices in Tennessee. NursingHomeClear cannot take or act on complaints.

Inspections and complaints: Tennessee Health Facilities Commission, Division of Licensure and Regulation, the state agency that inspects nursing homes for CMS and takes complaints about care.
Resident advocate: Tennessee Long-Term Care Ombudsman, Department of Disability and Aging, 877-236-0013. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.

Common questions

What is Life Care Center of Gray's Medicare star rating?: CMS rates Life Care Center of Gray 1 out of 5 stars overall, with 1 for health inspections, 4 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Life Care Center of Gray get at its last inspection?: 6 health deficiencies at the standard inspection on September 19, 2023. The Tennessee average is 4.4.
Has Life Care Center of Gray been fined?: Yes. CMS lists 1 fine totaling $10,039 in the last three years.
Does Life Care Center of Gray accept Medicaid?: It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Life Care Center of Gray?: CMS lists 7 owners and managers, and links the home to Life Care Centers of America. Legal business name: GRAY MEDICAL INVESTORS, LLC.

Sources

Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
Owners: CMS Ownership. Penalties: CMS Penalties.
Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.