Signature Healthcare of Putnam County
278 Dry Valley Rd, Cookeville, TN 38506 · Putnam County · (931) 537-6524
175 certified beds, about 139 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1980
CMS Care Compare ratings, data as of September 1, 2026 · CCN 445136 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 22, 2026, inspectors cited 2 health deficiencies (the Tennessee average is 4.4, the national average 9.2).
None of its 15 health citations since April 2019 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.67 hours per resident per day, against 3.80 across Tennessee and 3.86 nationally. Registered nurses accounted for 0.48 of those hours.
41.4% of nursing staff left within the year CMS measured (Tennessee average 48.9%).
CMS links it to Signature Healthcare, an affiliated group of 67 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.
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 15 health citations on file.
July 22, 2026Standard inspection · 2 citations
- D Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on facility policy review, medical record review, and interviews, the facility failed to report an allegation of staff to resident abuse for 1 resident (Resident #68) of 24 residents reviewed for abuse.
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on facility policy review, medical record review, observations, and interview, the facility failed to ensure respiratory equipment was stored properly for 2 residents (Residents #51 and #89) of 4 residents reviewed for respiratory care.
April 3, 2025Complaint inspection · 3 citations
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to revise a care plan to include fall interventions after 2 falls for 1 resident (Resident #40) of 4 care plans reviewed for falls.
- D 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, observations, and interviews, the facility failed to timely implement interventions to reduce the risk of falls for 1 resident (Resident #43) of 4 residents reviewed for falls.
- D Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspectors wroteBased on facility policy review, medical record review, facility documentation review, and interviews the facility failed to prevent loss or diversion of controlled medications (narcotics) for 1 resident (Resident #7) of 65 sampled residents reviewed for misappropriation of narcotics. The facility was cited as past non-compliance. Non-compliance began on [DATE] and ended on [DATE]. The facility is not required to submit a Plan of Correction for F-755.
May 18, 2023Standard inspection · 10 citations
- F Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspectors wroteBased on facility documentation, observation, and interview, the facility failed to have sufficient staffing for 1 of 4 (500) halls.
- F Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Inspectors wroteBased on facility document review, observation, and interview, the facility failed to serve food in a timely manner to 9 of 123 (Resident #9, #14, #15, #16, #39, #92, and #113) residents who ate food prepared by the facility.
- F Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on facility policy review, observation, and interview, the facility failed to maintain appropriate temperatures (temps) for food served on a test tray dated 5/15/2023. The facility also failed to maintain appropriate temps for food on the steam table requiring re-heating and a delay in food service.
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on facility policy review, facility maintenance documentation, observation, and interview, the facility failed to provide proper storage dating of foods. The facility also failed to provide proper sanitation of equipment after use and maintenance of equipment in the kitchen. The facility further failed to provide appropriately dated foods and sanitized equipment in 1 of 3 (500 hall) nutrition rooms.
- E Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on facility policy review, observation, and interview, the facility failed to serve silverware for 1 of 2 carts on the 500 hall during a meal.
- 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.
Inspectors wroteBased on facility policy review, observation, and interview, the facility failed to provide a homelike environment for 2 of 5 (100 and 500) halls.
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to revise the comprehensive care plan for 1 of 47 (Resident #22) sampled residents.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on facility policy review, medical record review, observation, and interview, the facility failed to assess and treat impaired skin integrity for 1 of 1 (Resident #4) sampled residents observed during the initial tour.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on medical record review, observation and interview, the facility failed to supervise intrusive wandering for 1 of 6 (Resident #41) sampled residents and failed to provide supervision for transport of 1 of 1 (Resident #60) sampled residents.
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on facility policy review, medical record review, observation, and interview, the facility failed to ensure safe handling, cleaning, and storage of breathing treatment and CPAP/BiPap (Continuous Positive Airway Pressure/Bilevel Positive Airway Pressure) equipment for 1 of 4 (Resident #44) sampled residents and failed to properly date and store oxygen equipment for 2 of 4 (Residents #66 and #77) sampled residents observed with oxygen therapy.
April 10, 2019Standard inspection · 0 citations
Fire safety inspections
3 fire safety citations on file: 1 on July 22, 2026, 1 on May 18, 2023, 1 on April 10, 2019.
Every fire safety citation3 citations
- D Provide properly protected cooking facilities.
- 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.
- D Meet requirements for the installation and maintenance of electrical systems.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
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) | 3.67 | 3.80 | 3.86 |
| Registered nurses | 0.48 | 0.60 | 0.69 |
| All nursing staff on weekends | 3.12 | 3.31 | 3.42 |
| Nurse aides | 2.20 | ||
| Licensed practical nurses | 0.99 | ||
| Nursing staff turnover (share who left in a year) | 41.4% | 48.9% | 45.8% |
| Registered nurse turnover | 26.7% | 43.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.44 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 3.89 on weekdays and 3.12 on weekends, 20% 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 3.61 in April to June 2025 to 3.67 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 | 3.67 | 0.48 | 3.89 | 3.12 | 0.0% | 0 of 90 | 139 |
| Oct to Dec 2025 | 3.52 | 0.49 | 3.69 | 3.10 | 0.0% | 0 of 92 | 139 |
| Jul to Sep 2025 | 3.54 | 0.45 | 3.76 | 2.99 | 0.0% | 0 of 92 | 137 |
| Apr to Jun 2025 | 3.61 | 0.45 | 3.89 | 2.91 | 0.0% | 0 of 91 | 136 |
| 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.
Staff pay reports
Staff pay at this home
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
Official wage estimates for Tennessee
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Tennessee, all employers | |||
| CNAs (nursing assistants) | $18.27 | $17.09 to $19.66 | 27,040 |
| LPNs and LVNs | $28.31 | $23.64 to $30.12 | 20,830 |
| Registered nurses | $39.18 | $36.28 to $45.79 | 72,200 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
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 | 13.0 | 14.0 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.6 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.6 | 1.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.4 | 3.4 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.7 | 1.7 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.7 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.8 | 5.0 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 19.7 | 16.9 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 25.3 | 22.6 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 8.7 | 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 | 0.3 | 1.6 | 1.8 |
Owners and operators
Legal business name: LP COOKEVILLE LLC. CMS links this home to Signature Healthcare, a group of 67 nursing homes averaging 3.1 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Shc LP Holdings LLC | 5% or greater direct ownership interest | Organization | 100% | 05/01/2014 |
| Asbr Holdings LLC | 5% or greater indirect ownership interest | Organization | 05/01/2018 | |
| Jjla LLC | 5% or greater indirect ownership interest | Organization | 05/01/2014 | |
| Lpsnf LLC | 5% or greater indirect ownership interest | Organization | 05/01/2014 | |
| Wheaten LLC | 5% or greater indirect ownership interest | Organization | 05/01/2014 | |
| Steier III, Elmer | 5% or greater indirect ownership interest | Individual | 05/01/2014 | |
| Boone, Paula | W-2 managing employee | Individual | 01/16/2023 | |
| Harrison, John | Corporate officer | Individual | 05/01/2014 |
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 do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 5 problems in this area, most recently on July 22, 2026: "Provide safe and appropriate respiratory care for a resident when needed."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 3 problems in this area, most recently on May 18, 2023: "Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service."
- When is the care plan meeting, and can family attend it?Inspectors cited 2 problems in this area, most recently on April 3, 2025: "Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals."
- 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 May 18, 2023: "Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.12 hours per resident per day, below the Tennessee average of 3.31.
Other nursing homes nearby
- Grandview Post Acute Cookeville, 2.6 mi · 1 of 5 stars · 37 citations
- NHC Healthcare, Cookeville Cookeville, 4.2 mi · 5 of 5 stars · 5 citations
- Standing Stone Care and Rehab Monterey, 10.4 mi · 5 of 5 stars · 9 citations
- Overton County Health and Rehab Center Livingston, 15.2 mi · 4 of 5 stars · 5 citations
- Life Care Center of Sparta Sparta, 16.3 mi · 5 of 5 stars · 5 citations
- Mabry Health Care Gainesboro, 16.4 mi · 3 of 5 stars · 8 citations
- NHC Healthcare, Sparta Sparta, 18 mi · 3 of 5 stars · 7 citations
- Wharton Nursing Home Pleasant Hill, 20.1 mi · 1 of 5 stars · 18 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 Signature Healthcare of Putnam County's Medicare star rating?
- CMS rates Signature Healthcare of Putnam County 2 out of 5 stars overall, with 2 for health inspections, 2 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Signature Healthcare of Putnam County get at its last inspection?
- 2 health deficiencies at the standard inspection on July 22, 2026. The Tennessee average is 4.4.
- Has Signature Healthcare of Putnam County been fined?
- CMS lists no fines in the last three years.
- Does Signature Healthcare of Putnam County 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 Signature Healthcare of Putnam County?
- CMS lists 8 owners and managers, and links the home to Signature Healthcare. Legal business name: LP COOKEVILLE 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.