Below average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Signature Healthcare Of Putnam County during CMS and state inspections, most recent first.
Failure to report an alleged staff-to-resident abuse incident involving a resident with stroke, dementia, depression, and severe cognitive impairment. A nurse heard a CNA and the resident arguing, then found the resident agitated and stating the CNA had hit her in the eye. The DON and ADM confirmed the allegation was not reported to the State or other officials, even though an investigation was started and the allegation was later found unsubstantiated.
Nebulizer masks for two residents were found uncovered and open to air on bedside tables instead of being stored per facility policy in a plastic bag labeled with the resident's name and date. One resident had COPD, dementia, and asthma with nebulizer orders for Albuterol and Budesonide, and the other had Myasthenia Gravis and Dysphagia with an Albuterol nebulizer order. The DON confirmed the masks were not stored properly.
A resident with severe cognitive impairment, hemiplegia, and a history of falls experienced two falls, after which new interventions such as removing a wheelchair cushion, moving the resident closer to the nurses' station, and conducting a medication review for dizziness were identified but not added to the care plan. The care plan was not revised to include these interventions, despite facility policy requiring updates after such incidents, as confirmed by medical record review and DON interview.
A resident with severe cognitive impairment and mobility issues experienced multiple falls from a wheelchair, and the facility did not timely implement new fall prevention interventions after each incident. Physical Therapy evaluations and recommendations for a specialty wheelchair were delayed, and previously established interventions were repeated instead of introducing new measures. Facility staff confirmed the lack of timely action following each fall.
A resident receiving opioid pain medication experienced a loss of a bubble pack containing 30 oxycodone-acetaminophen tablets after two nurses failed to follow the facility's required procedure for counting and reconciling controlled medications at shift change. The incomplete count, attributed in part to one nurse being in a rush, resulted in the discrepancy going unnoticed until a later audit, despite the resident not missing any doses and having controlled pain levels.
Failure to Report Alleged Staff-to-Resident Abuse
Penalty
Summary
The facility failed to report an allegation of staff-to-resident abuse involving one resident. The resident had diagnoses including stroke, dementia, and depression, and a quarterly MDS assessment showed a BIMS score of 5, indicating severe cognitive impairment. According to the nurse’s note, a nurse heard a CNA and the resident arguing around 4:00 AM, then found the resident agitated, holding the CNA’s arm, and stating that the CNA had hit her in the eye and that she wanted the CNA out of the room. The resident was assisted with care, had no bruising noted on initial examination, and was monitored for delayed bruising. The DON stated she was aware of the allegation of abuse but confirmed it was not reported to the state or other officials. The Administrator stated he was notified of the allegation, an investigation was started, and the allegation was found unsubstantiated, but he also confirmed it was not reported to the State or any other officials. The RN who witnessed the event stated she recalled the allegation and reported it to her supervisor.
Nebulizer masks left uncovered and not stored properly
Penalty
Summary
The facility failed to ensure respiratory equipment was stored properly for 2 residents reviewed for respiratory care. Facility policy titled, Medication Administration Nebulizers [Updraft], dated 1/2023, required nebulizers to be stored in a plastic bag with the resident's name and date on it. For Resident #51, the medical record showed diagnoses including COPD, dementia, and asthma, with physician orders for Albuterol Sulfate Solution via nebulizer as needed and Budesonide Suspension via nebulization twice daily. The resident's care plan addressed asthma and medication administration as ordered, and the MDS indicated severe cognitive impairment. The MAR showed the resident received breathing treatments as ordered. During observation on 7/20/2026 at 11:13 AM, Resident #51's nebulizer mask was uncovered, open to air, and laying on top of the bedside table. For Resident #89, the medical record showed diagnoses of Myasthenia Gravis and Dysphagia, with an order for Albuterol Sulfate Solution via nebulizer three times a day. The resident's MDS indicated cognitive intactness, the care plan addressed medications as ordered, and the MAR showed breathing treatments were received as ordered. During observation on 7/20/2026 at 10:54 AM, Resident #89's nebulizer mask was also uncovered, open to air, and laying on top of the bedside table. The DON confirmed on 7/21/2026 at 8:09 AM that the nebulizer masks for both residents were not stored properly.
Failure to Update Care Plan with Fall Interventions After Multiple Incidents
Penalty
Summary
The facility failed to revise and update the care plan for a resident after two separate fall incidents, despite facility policies requiring care plan updates with each new review and after changes in a resident's condition. The resident, who had severe cognitive impairment, hemiplegia, impaired mobility, and a history of falls, experienced two falls within a short period. After the first fall, interventions such as removing the wheelchair cushion and moving the resident closer to the nurses' station were identified, but these were not added to the resident's care plan. Following the second fall, which involved the resident attempting to reach his dresser and reporting dizziness, a medication review was recommended, but this intervention was also not incorporated into the care plan. Medical record reviews confirmed that the care plan was not updated to reflect these new interventions, and interviews with the DON verified that the required changes were not made. The resident's care plan continued to lack documentation of the specific fall interventions and did not address the resident's complaints of dizziness or the recommended medication review, despite clear facility policy and assessment findings indicating the need for such updates.
Failure to Timely Implement Fall Prevention Interventions
Penalty
Summary
The facility failed to timely implement fall prevention interventions for a resident with severe cognitive impairment and significant mobility limitations. The resident, who had diagnoses including dementia, altered mental status, muscle weakness, abnormal walking and mobility, and mood disorder, required maximum staff assistance for standing and transfers. After a fall from the wheelchair, the intervention was for Physical Therapy (PT) to evaluate the resident, but PT services did not begin until four days later. Following a subsequent fall, PT was again to assess for a different wheelchair, but this evaluation was delayed by five days, and no new assessment or evaluation for a different wheelchair was conducted as planned. The specialty wheelchair recommended by PT had not arrived at the facility by the time of the survey. Additionally, after a third fall, the intervention was to move the resident's personal items closer for easier reach, but this was not a new intervention, as it had already been included in the care plan prior to the fall. Observations confirmed the resident continued to use a tilted wheelchair with an anti-thrust cushion, and interviews with facility staff, including the Director of Rehabilitation and the Director of Nursing, confirmed that fall interventions were not implemented in a timely manner after each incident.
Failure to Prevent Loss of Controlled Medication Due to Incomplete Narcotic Count
Penalty
Summary
The facility failed to prevent the loss or diversion of controlled medications for one resident, resulting in a deficiency related to pharmaceutical services. According to the facility's policy, controlled medications are to be handled, stored, and documented in accordance with federal and state regulations, including a physical inventory at each shift change by two staff members. However, on one occasion, the required process for counting and reconciling controlled medications was not followed. Specifically, two nurses did not count the medication cards and individual resident narcotic record sheets together as required, and one nurse was reportedly in a rush, leading to an incomplete count. The incident involved a resident who was cognitively intact and receiving opioid pain medication for chronic pain, among other diagnoses. The resident was prescribed oxycodone-acetaminophen, and the facility received and signed for 90 tablets. During a routine count, it was discovered that a bubble pack card containing 30 tablets was missing, even though the resident had not missed any doses and pain assessments indicated controlled pain levels. The discrepancy was identified when the DON and other staff attempted to reconcile the medication cards and narcotic sheets, finding that the numbers did not match the records. Interviews with staff confirmed that the established procedure for controlled medication counts was not followed on the day in question. The nurses involved admitted that they did not count both the medication cards and the narcotic record sheets together, as required by policy. The missing medication was reported to the appropriate authorities, and a police report was filed. The facility's failure to adhere to its own controlled medication policy led to the loss of a controlled substance for the resident.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Cookeville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Grandview Post Acute | 2.6 mi | ★★★★★ | 2 | 0 |
| Nhc Healthcare, Cookeville | 4.2 mi | ★★★★★ | 6 | 0 |
| Standing Stone Care And Rehab | 10.4 mi | ★★★★★ | 3 | 0 |
| Overton County Health And Rehab Center | 15.2 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Sparta | 16.3 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release October 2026) and official state health department websites.