The Waters of Union City , LLC
1105 Sunswept Dr, Union City, TN 38261 · Obion County · (731) 885-6400
80 certified beds, about 55 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1981
CMS Care Compare ratings, data as of September 1, 2026 · CCN 445138 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on March 18, 2026, inspectors cited 2 health deficiencies (the Tennessee average is 4.4, the national average 9.2).
None of its 9 health citations since September 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 3.32 hours per resident per day, against 3.80 across Tennessee and 3.86 nationally. Registered nurses accounted for 0.57 of those hours.
42.6% of nursing staff left within the year CMS measured (Tennessee average 48.9%).
CMS links it to Infinity Healthcare Consulting, an affiliated group of 70 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 9 health citations on file.
March 18, 2026Standard inspection · 2 citations
- D Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to assure residents received care and services for the provision of parenteral fluids for 1 of 1 sampled resident (Resident #66) reviewed for a peripheral inserted central catheter (PICC) line.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on facility policy review, medical record review, observation, and interview, the facility failed to ensure the prevention and spread of infection when 1 of 4 staff (Registered Nurse (RN) A) failed to use appropriate Personal Protective Equipment (PPE) during medication administration through a Peripherally Inserted Central Catheter (PICC) for 1 of 8 (Residents #66) sampled residents reviewed for medication administration.
January 30, 2025Standard inspection · 3 citations
- D Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Inspectors wroteBased on policy review, record review, and interview the facility failed to provide information to the residents regarding their right to refuse medical or surgical treatment or to formulate an advance directive for 8 of 24 (Resident #1, #2, #4, #11, #13, #20, #22, and #47) residents reviewed for Advance Directives.
- 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.
Inspectors wroteBased on policy review, medical record review, and interview, the facility failed to ensure behavior monitoring and side effects of psychoactive medications were monitored for 1 of 5 sampled residents (Resident #256) reviewed for unnecessary medications.
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on the facility policy review, medical record review, observations, and interview, the facility failed to minimize the potential for foodborne illness transmission by not properly monitoring temperatures for 2 of 46 (Resident #10 and Resident #27) personal refrigerators located in resident rooms.
September 25, 2019Standard inspection · 4 citations
- D Assure that each resident’s assessment is updated at least once every 3 months.
Inspectors wroteBased on review of the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual, medical record review, and interview, the facility failed to complete a quarterly assessment, using the Centers for Medicare & Medicaid Services-specific RAI process within the regulatory time frames for 2 of 19 (Resident #2 and #5) sampled residents reviewed.
- D Ensure medication error rates are not 5 percent or greater.
Inspectors wroteBased on review of the GERIATRIC MEDICATION HANDBOOK, 11TH Edition provided by the American Society of Consultant Pharmacists, medical record review, observation, and interview, the facility failed to ensure 1 of 3 (Registered Nurse (RN) #1) nurses administered medications with a medication error rate of less than 5 percent (%). A total of 3 errors were observed out of 29 opportunities, resulting in an error rate of 10.34482759%
- D Ensure that residents are free from significant medication errors.
Inspectors wroteBased on review of the GERIATRIC MEDICATION HANDBOOK, 11TH edition provided by the American Society of Consultant Pharmacists, medical record review, observation, and interview, the facility failed to ensure 1 of 3 (Registered Nurse (RN) #1) nurses administered medications free of significant medication errors.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on policy review, medical record review, observation, and interview, the facility failed to ensure practices to prevent the potential spread of infection were maintained for 1 of 2 (Resident #48) sampled residents observed during a dressing change.
Fire safety inspections
6 fire safety citations on file: 2 on March 18, 2026, 3 on January 30, 2025, 1 on September 25, 2019.
Every fire safety citation6 citations
- D Have restrictions on the use of portable space heaters.
- D Have generator or other power source capable of supplying service within 10 seconds.
- 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 Install an approved automatic sprinkler system.
- D Ensure proper usage of power strips and extension cords.
- D Ensure proper usage of power strips and extension cords.
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) | 3.32 | 3.80 | 3.86 |
| Registered nurses | 0.57 | 0.60 | 0.69 |
| All nursing staff on weekends | 3.00 | 3.31 | 3.42 |
| Nurse aides | 1.74 | ||
| Licensed practical nurses | 1.01 | ||
| Nursing staff turnover (share who left in a year) | 42.6% | 48.9% | 45.8% |
| Registered nurse turnover | 25.0% | 43.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.77 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 3.44 on weekdays and 3.00 on weekends, 13% 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 3.56 in April to June 2025 to 3.32 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 | 3.32 | 0.57 | 3.44 | 3.00 | 0.0% | 0 of 90 | 55 |
| Oct to Dec 2025 | 3.31 | 0.51 | 3.43 | 3.01 | 0.0% | 0 of 92 | 56 |
| Jul to Sep 2025 | 3.60 | 0.62 | 3.75 | 3.20 | 0.0% | 0 of 92 | 54 |
| Apr to Jun 2025 | 3.56 | 0.57 | 3.74 | 3.11 | 3.3% | 0 of 91 | 59 |
| 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 | 3.3 | 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 | 2.3 | 1.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.3 | 3.4 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.4 | 1.7 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 5.0 | 17.2 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.3 | 5.0 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 25.6 | 16.9 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 35.5 | 22.6 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 7.4 | 11.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.2 | 1.7 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.6 | 1.6 | 1.8 |
Owners and operators
Legal business name: THE WATERS OF UNION CITY LLC. CMS links this home to Infinity Healthcare Consulting, a group of 70 nursing homes averaging 2.1 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| A&f Realty LLC | 5% or greater direct ownership interest | Organization | 20% | 09/01/2016 |
| Keeling, David | W-2 managing employee | Individual | 09/01/2019 |
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 medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 3 problems in this area, most recently on January 30, 2025: "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."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 2 problems in this area, most recently on March 18, 2026: "Provide and implement an infection prevention and control program."
- 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 March 18, 2026: "Provide for the safe, appropriate administration of IV fluids for a resident when needed."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 1 problem in this area, most recently on January 30, 2025: "Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.00 hours per resident per day, below the Tennessee average of 3.31.
Other nursing homes nearby
- Union City Health and Rehabilitation Union City, 0.2 mi · 1 of 5 stars · 10 citations
- Obion County Nursing Home Union City, 5.2 mi · 2 of 5 stars · 22 citations
- Vanayer Senior Living and Rehabilitation Martin, 10.6 mi · 3 of 5 stars · 9 citations
- Fulton Nursing and Rehabilitation, LLC Fulton, 10.7 mi · 1 of 5 stars · 7 citations
- Diversicare of Martin Martin, 10.8 mi · 5 of 5 stars · 8 citations
- Clinton-Hickman County Nursing Facility Clinton, 17.2 mi · 4 of 5 stars · 4 citations
- Clinton Place Clinton, 17.5 mi · 2 of 5 stars · 14 citations
- Weakley Rehabilitation and Nursing Center Dresden, 20.4 mi · 1 of 5 stars · 27 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 The Waters of Union City , LLC's Medicare star rating?
- CMS rates The Waters of Union City , LLC 5 out of 5 stars overall, with 5 for health inspections, 2 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did The Waters of Union City , LLC get at its last inspection?
- 2 health deficiencies at the standard inspection on March 18, 2026. The Tennessee average is 4.4.
- Has The Waters of Union City , LLC been fined?
- CMS lists no fines in the last three years.
- Does The Waters of Union City , LLC 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 The Waters of Union City , LLC?
- CMS lists 2 owners and managers, and links the home to Infinity Healthcare Consulting. Legal business name: THE WATERS OF UNION CITY 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.