NHC Healthcare, Smithville
825 Fisher Ave Po Box 549, Smithville, TN 37166 · De Kalb County · (615) 597-4284
114 certified beds, about 84 residents a day · For profit - Corporation · Medicare and Medicaid since 1977
Certified for Medicaid Certified for Medicare
Overall
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 445116 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 21, 2026, inspectors cited 0 health deficiencies (the Tennessee average is 4.4, the national average 9.2).
Of 9 health citations since November 2019, 3 were rated as actual harm or immediate jeopardy to residents (2 immediate jeopardy).
CMS lists 1 fine totaling $228,511 in the last three years; the largest was $228,511, and the latest is dated April 11, 2024.
Nurses and nurse aides worked 3.82 hours per resident per day, against 3.80 across Tennessee and 3.86 nationally. Registered nurses accounted for 0.61 of those hours.
42.2% of nursing staff left within the year CMS measured (Tennessee average 48.9%).
CMS links it to National Healthcare Corporation, an affiliated group of 71 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.
011/19
704/24
202/25
005/26
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 9 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
1J
1K
0L
Actual harm
1G
0H
0I
Potential for more than minimal harm
6D
0E
0F
Potential for minimal harm
0A
0B
0C
May 21, 2026Standard inspection · 0 citations
February 27, 2025Standard inspection · 2 citations
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to resubmit a Pre-admission Screening and Resident Review (PASRR) to include an active mental health condition present upon admission for 1 resident (Resident #74) of 7 residents reviewed for PASRR.
- D Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on facility policy review, medical record review, and interviews, the facility failed to ensure the medical record was accurate for 1 resident (Resident #37) of 25 residents reviewed for accurate medical records.
April 11, 2024Complaint inspection · 7 citations
- K Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Inspectors wroteBased on facility policy review, facility investigation review, medical record review, observation, and interview the facility failed to provide an environment free from abuse for 5 of 9 sampled residents (Resident #1, Resident #2, Resident #6, Resident #7 and Resident #8) reviewed for abuse. On [DATE] Resident #2, a vulnerable, severely cognitively impaired, ambulatory female resident wandered into Resident #1's room. Resident #1, an alert male resident with a Brief Interview for Mental Status (BIMS) score of 15 and an extensive psychiatric history, willfully hit Resident #2 multiple times on her head and back. On [DATE] Resident #7, a vulnerable, severely cognitively impaired, female resident in a wheelchair, bumped into Resident #1's wheelchair in the dining room. Resident #1 was verbally abusive and called Resident #7 derogatory names. [...]
- J Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on facility policy review, medical record review, www.wunderground.com, Electrical Company invoice, observation and interview, the facility failed to provide adequate supervision to prevent an accident for 2 (Resident #5 and Resident #10) of 6 sampled residents reviewed for accidents. The facility failed to ensure adequate supervision to prevent an exit seeking, wandering, cognitively impaired resident (Resident #10) with a Brief Interview for Mental Status (BIMS) score of 9, assessed to be an elopement risk, from leaving a safe environment and exiting the facility to an unsafe environment. Resident #10 (wearing a wander guard bracelet) exited a double door connected to the door alarm/wander guard system that malfunctioned on [DATE] at an unknown time until [DATE] at 2:00 AM. No alarm was activated when Resident #10 exited through the double doors. [...]
- G Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on facility policy review, medical record review, observations, and interviews, the facility failed to develop and implement a comprehensive person-centered care plan for 2 of 17 residents sampled (Resident #5 and Resident #7) that resulted in actual harm for Resident #5.
- D Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on facility policy review, Facility Reported Investigation (FRI) review, medical record review, and interview, the facility failed to report allegations of abuse within 2 hours for 4 of 9 (Resident #1, Resident #7, Resident #6, and Resident #8) sampled residents reviewed for abuse. The facility failed to report the 5-day investigation of abuse for 2 of 9 (Resident #3 and Resident #4) residents reviewed for abuse.
- D Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Inspectors wroteBased on facility policy review, job description review, employee file review, medical record review, observation, and interview, the facility failed to provide competent and proficient nursing staff to assure residents' safety and attain or maintain the highest practicable physical wellbeing for 3 of 17 (Resident #5, Resident #7 and Resident #6) sampled residents reviewed. The facility failed to have a person-centered appropriate intervention in place to prevent a second fall for Resident #5 on 1/23/2024, which resulted in a head injury. The nurse failed to provide pertinent details related to a fall with a head injury for Resident #5 who was on long term use of an anticoagulant (blood thinner). Resident #1 and Resident #7 were involved in a resident-to-resident altercation on 3/9/2024 which resulted in verbal abuse with Resident #7. [...]
- D Observe each nurse aide's job performance and give regular training.
Inspectors wroteBased on record review and interview, the facility failed to conduct yearly performance evaluations for 2 of 6 Certified Nurse Assistant (CNA MM and CNA NN) personnel files reviewed.
- D Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspectors wroteBased on facility policy review, Facility Reported Investigation review, medical record review, observation, and interview, the facility's Quality Assurance Performance Improvement (QAPI) committee failed to monitor implemented plans of action for a resident-to-resident abuse.
November 20, 2019Standard inspection · 0 citations
Fire safety inspections
19 fire safety citations on file: 3 on May 21, 2026, 15 on February 27, 2025, 1 on November 20, 2019.
Every fire safety citation19 citations
- F Have generator or other power source capable of supplying service within 10 seconds.
- D Install corridor and hallway doors that block smoke.
- D Meet requirements for the installation and maintenance of electrical systems.
- D Provide primary/alternate means for communication.
- D Have corridors or aisles that are unobstructed and are at least 8 feet in width.
- D Have exits that are accessible at all times.
- D Provide properly protected cooking facilities.
- D Inspect, test, and maintain automatic sprinkler systems.
- D Install corridor and hallway doors that block smoke.
- D Meet other general requirements that are deficient.
- D Have properly installed electrical wiring and gas equipment.
- D Ensure that HVAC heat units are suspended and out of the reach of patients and can be shut off if unit is working improperly.
- D Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- D Provide properly sized and located linen or trash receptacles.
- D To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- D Have generator or other power source capable of supplying service within 10 seconds.
- D Ensure proper usage of power strips and extension cords.
- D Have proper medical gas storage and administration areas.
- D Meet requirements for sections of health care facilities separated by fire resistive construction.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| April 11, 2024 | Fine | $228,511 |
| April 11, 2024 | Payment Denial | 40 days from May 10, 2024 |
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) | 3.82 | 3.80 | 3.86 |
| Registered nurses | 0.61 | 0.60 | 0.69 |
| All nursing staff on weekends | 3.37 | 3.31 | 3.42 |
| Nurse aides | 2.44 | ||
| Licensed practical nurses | 0.77 | ||
| Nursing staff turnover (share who left in a year) | 42.2% | 48.9% | 45.8% |
| Registered nurse turnover | 37.5% | 43.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.15 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 4.00 on weekdays and 3.37 on weekends, 16% 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 3.82 in April to June 2025 to 3.82 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 | 3.82 | 0.61 | 4.00 | 3.37 | 0.0% | 0 of 90 | 84 |
| Oct to Dec 2025 | 3.78 | 0.53 | 3.96 | 3.32 | 0.0% | 0 of 92 | 83 |
| Jul to Sep 2025 | 3.83 | 0.51 | 3.99 | 3.43 | 0.0% | 0 of 92 | 85 |
| Apr to Jun 2025 | 3.82 | 0.49 | 3.94 | 3.52 | 0.0% | 0 of 91 | 80 |
| 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 | 6.4 | 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 | 1.0 | 1.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.4 | 3.4 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.7 | 1.7 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 5.2 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 0.9 | 5.0 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 10.8 | 16.9 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 17.2 | 22.6 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 17.3 | 11.2 | 12.0 |
Owners and operators
Legal business name: NHC HEALTHCARE-SMITHVILLE LLC. CMS links this home to National Healthcare Corporation, a group of 71 nursing homes averaging 4 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Morgan Stanley Institutional Advisors LLC | Indirect ownership interest | Organization | 11/08/2024 | |
| NHC/Delaware Inc | Indirect ownership interest | Organization | 07/01/2000 | |
| Bidwell, Gregory | Managing control - governing body | Individual | 07/01/2000 | |
| Bidwell, Gregory | Corporate officer | Individual | 07/01/2000 | |
| National Healthcare Corporation | Operational/managerial control | Organization | 07/01/2000 | |
| NHC-Op LP | Operational/managerial control | Organization | 07/01/2000 | |
| Bidwell, Gregory | Operational/managerial control | Individual | 07/01/2000 | |
| Dodson, Vicki | Operational/managerial control | Individual | 06/01/2019 | |
| Kidd, Brian | Operational/managerial control | Individual | 01/01/2017 | |
| Panter, Lori | Operational/managerial control | Individual | 05/18/2020 | |
| Sherwood, William | Operational/managerial control | Individual | 01/01/2025 | |
| Ussery, Robert | Operational/managerial control | Individual | 07/01/2000 | |
| Vaden, Ryan | Operational/managerial control | Individual | 10/11/2019 | |
| Blackrock Inc | Adp of the SNF | Organization | 01/20/2010 | |
| National Health Corporation | Adp of the SNF | Organization | 06/02/2025 | |
| National Healthcare Corporation | Adp of the SNF | Organization | 03/24/2025 | |
| Vanguard Group Inc | Adp of the SNF | Organization | 11/30/2006 | |
| Dodson, Vicki | Adp of the SNF | Individual | 06/01/2019 | |
| Kidd, Brian | Adp of the SNF | Individual | 01/01/2017 | |
| Sherwood, William | Adp of the SNF | Individual | 03/30/2025 | |
| Vaden, Ryan | Adp of the SNF | Individual | 03/30/2025 |
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.
- When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on February 27, 2025: "Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 2 problems in this area, most recently on April 11, 2024: "Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody."
- How many nurses and aides work each shift, nights and weekends included?Inspectors cited 2 problems in this area, most recently on April 11, 2024: "Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 1 problem in this area, most recently on April 11, 2024: "Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents."
Other nursing homes nearby
- Woodbury Health and Rehabilitation Center Woodbury, 16.4 mi · 3 of 5 stars · 14 citations
- Willow Branch Health and Rehabilitation McMinnville, 18 mi · 2 of 5 stars · 11 citations
- Life Care Center of Sparta Sparta, 19 mi · 5 of 5 stars · 5 citations
- NHC Healthcare, McMinnville McMinnville, 19.2 mi · 5 of 5 stars · 4 citations
- NHC Healthcare, Sparta Sparta, 20.6 mi · 3 of 5 stars · 7 citations
- NHC Healthcare, Cookeville Cookeville, 21.9 mi · 5 of 5 stars · 5 citations
- Smith County Health and Rehabilitation Carthage, 23 mi · 5 of 5 stars · 6 citations
- Grandview Post Acute Cookeville, 23.8 mi · 1 of 5 stars · 37 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 NHC Healthcare, Smithville's Medicare star rating?
- CMS rates NHC Healthcare, Smithville 3 out of 5 stars overall, with 2 for health inspections, 3 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did NHC Healthcare, Smithville get at its last inspection?
- 0 health deficiencies at the standard inspection on May 21, 2026. The Tennessee average is 4.4.
- Has NHC Healthcare, Smithville been fined?
- Yes. CMS lists 1 fine totaling $228,511 in the last three years.
- Does NHC Healthcare, Smithville 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 NHC Healthcare, Smithville?
- CMS lists 21 owners and managers, and links the home to National Healthcare Corporation. Legal business name: NHC HEALTHCARE-SMITHVILLE 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.