SNF
PICKETT CARE AND REHABILITATION CENTER
CCN: 445390 · BYRDSTOWN, TN 38549 · Pickett County
CCRC
Overview
- Address
- 129 HILLCREST DRIVE, BYRDSTOWN, TN 38549
- Phone
- 9318643162
- Certified beds
- 69
- Avg daily residents
- 52 (76% of beds filled)
- Ownership
- For-profit LLC
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 1997-04-01
- Setting
- Rural
3 /5
★★★★★
CMS Overall Rating
CMS 5-Star Ratings
CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.
Staffing & Workforce
Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.
| Role | Reported | Case-mix expected | Adjusted | Federal floor | |
|---|---|---|---|---|---|
| Total nurse All nursing staff combined: RN + LPN + Aide | 3.79 | 3.78 | 3.87 | ≥ 3.48 | |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.60 | 0.66 | 0.61 | ≥ 0.55 | |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 1.24 | 0.84 | 1.26 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 1.95 | 2.28 | 2.00 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.83 | — | — | — | |
| Physical therapist Rehabilitation therapist hours — important for post-acute / rehab admissions. | 0.22 | — | — | — |
Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.
Weekend staffing
Total nurse (weekend)
2.99
hrs / resident / day
RN (weekend)
0.43
hrs / resident / day
Total nurse (adjusted, weekend)
3.06
hrs / resident / day
Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.
Staff turnover
Total nursing staff turnover
45.2%
annual
RN turnover
40.0%
annual
Administrators departed
0
last 12 months
Resident acuity
Nursing Case-Mix Index
1.34
higher acuity than avg
Case-Mix Index Ratio
0.97
facility / state ratio
Health Inspections
CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.
| Cycle | Date | Total defs. | Standard | Complaint | Deficiency score | Revisits | Total score |
|---|---|---|---|---|---|---|---|
| Cycle 1 (most recent) | 2025-04-09 | 6 | 6 | 0 | 24 | 1 | 24 |
| Cycle 2/3 (prior) | 2021-11-17 | 9 | 7 | 2 | 36 | 1 | 36 |
Total weighted health score
27.0
lower is better
Deficiencies (17)
Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).
15 D/E/F Actual harm — potential for minor
2 G/H/I Actual harm
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0641 | Ensure each resident receives an accurate assessment. | D | 2025-04-09 | 2025-05-14 |
| 0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | 2025-04-09 | 2025-05-14 |
| 0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2025-04-09 | 2025-05-14 |
| 0814 | Dispose of garbage and refuse properly. | D | 2025-04-09 | 2025-05-14 |
| 0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | D | 2025-04-09 | 2025-05-14 |
| 0880 | Provide and implement an infection prevention and control program. | D | 2025-04-09 | 2025-05-14 |
| 0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | 2025-02-12 | 2025-02-27 |
| 0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | 2025-02-12 | 2024-04-12 |
| 0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | 2021-11-17 | 2021-12-10 |
| 0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2021-11-17 | 2021-12-10 |
| 0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | 2021-11-17 | 2021-12-10 |
| 0711 | Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. | D | 2021-11-17 | 2021-12-10 |
| 0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | 2021-11-17 | 2021-12-10 |
| 0880 | Provide and implement an infection prevention and control program. | D | 2021-11-17 | 2021-12-10 |
| 0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | D | 2021-11-17 | 2021-12-10 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | G | 2019-08-14 | 2019-11-19 |
| 0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | 2019-08-14 | 2019-11-19 |
Financial Health (FY 2023)
Payer mix (share of resident days)
Medicare 11.9% Medicaid 74.0% Other 14.1%
Operating performance
Operating Margin
-6.7%
Total Margin
-0.5%
Occupancy Rate
83.2%
Cost per Resident Day
$46
Revenue & costs
Net Patient Revenue
$6.6M
Total Costs
$967K
Net Income
-$35K
Balance sheet
Total Assets
$1.7M
Total Liabilities
$3.5M
Fund Balance
-$1.8M
Current Ratio
0.35
Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Chain: SIGNATURE HEALTHCARE
- Chain ID
474- Facilities in chain
- 71
- Legal business name
- LP BYRDSTOWN LLC
Chain-average star ratings (for peer context)
Overall
3.0
Health
2.8
Staffing
2.6
QM
3.8
Owner / manager organizations (6)
| Organization | Role | Association |
|---|---|---|
| LP CR HOLDINGS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | since 11/01/2007 |
| AGEMO HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 10/01/2016 |
| JJLA LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 11/01/2007 |
| LPSNF II LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 10/01/2016 |
| WHEATEN LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 11/01/2007 |
| SIGNATURE HEALTHCARE LLC | OPERATIONAL/MANAGERIAL CONTROL | since 11/01/2007 |
Owner / manager individuals (4)
| Name | Role | Association |
|---|---|---|
| SMEDRA, IRA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 11/01/2007 |
| STEIER III, ELMER | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 11/01/2007 |
| HARRISON, JOHN | CORPORATE OFFICER | since 11/01/2007 |
| FOSTER, NOAH | W-2 MANAGING EMPLOYEE | since 05/23/2023 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- Yes
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Yes
- Abuse citation flag
- No
Methodology & sources
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2023, downloaded 2026-04-14 , 14,120 rows.
All Data
Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.
Show 113 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $46 | metrics.cost_per_resident_day |
| Cost Report | Current Ratio | 0.35 | metrics.current_ratio |
| Cost Report | fiscal_year | 2,023 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 74.0% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 11.9% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $-35,164 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $6,608,075 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 83.2% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | -6.7% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $1,676,870 | metrics.total_assets |
| Cost Report | Total Costs ($) | $967,012 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $-1,817,736 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $3,494,606 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | -0.5% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 1.26403 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 1.99629 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 0.61094 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 3.87127 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 3.05997 | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Administrator turnover footnote | — | Administrator turnover footnote |
| Provider Information | Automatic Sprinkler Systems in All Required Areas | Yes | Automatic Sprinkler Systems in All Required Areas |
| Provider Information | Average Number of Residents per Day | 52.1 | Average Number of Residents per Day |
| Provider Information | Average Number of Residents per Day Footnote | — | Average Number of Residents per Day Footnote |
| Provider Information | Case-Mix LPN Staffing Hours per Resident per Day | 0.83803 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 2.27758 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.66055 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 3.77616 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 3.32828 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | 2.8 | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | 3.0 | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | 3.8 | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | 2.6 | Chain Average Staffing Rating |
| Provider Information | Chain ID | 474 | Chain ID |
| Provider Information | Chain Name | SIGNATURE HEALTHCARE | Chain Name |
| Provider Information | City/Town | BYRDSTOWN | City/Town |
| Provider Information | CMS Certification Number (CCN) | 445390 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | Y | Continuing Care Retirement Community |
| Provider Information | County/Parish | Pickett | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 1997-04-01 | Date First Approved to Provide Medicare and Medicaid Services |
| Provider Information | Geocoding Footnote | — | Geocoding Footnote |
| Provider Information | Health Inspection Rating | 3 | Health Inspection Rating |
| Provider Information | Health Inspection Rating Footnote | — | Health Inspection Rating Footnote |
| Provider Information | Latitude | 36.5723 | Latitude |
| Provider Information | Legal Business Name | LP BYRDSTOWN LLC | Legal Business Name |
| Provider Information | Location | 129 HILLCREST DRIVE,BYRDSTOWN,TN,38549 | Location |
| Provider Information | Long-Stay QM Rating | 4 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -85.136 | Longitude |
| Provider Information | Most Recent Health Inspection More Than 2 Years Ago | N | Most Recent Health Inspection More Than 2 Years Ago |
| Provider Information | Number of administrators who have left the nursing home | 0 | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 69 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | — | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | 71 | Number of Facilities in Chain |
| Provider Information | Number of Fines | 0 | Number of Fines |
| Provider Information | Number of Payment Denials | 0 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.33772 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 0.97102 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 3 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | For profit - Limited Liability company | Ownership Type |
| Provider Information | Physical Therapist Staffing Footnote | — | Physical Therapist Staffing Footnote |
| Provider Information | Processing Date | 2026-03-01 | Processing Date |
| Provider Information | Provider Address | 129 HILLCREST DRIVE | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | PICKETT CARE AND REHABILITATION CENTER | Provider Name |
| Provider Information | Provider Resides in Hospital | N | Provider Resides in Hospital |
| Provider Information | Provider SSA County Code | 680 | Provider SSA County Code |
| Provider Information | Provider Type | Medicare and Medicaid | Provider Type |
| Provider Information | QM Rating | 4 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 24 | Rating Cycle 1 Health Deficiency Score |
| Provider Information | Rating Cycle 1 Health Revisit Score | 0 | Rating Cycle 1 Health Revisit Score |
| Provider Information | Rating Cycle 1 Number of Complaint Health Deficiencies | 0 | Rating Cycle 1 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 1 Number of Health Revisits | 1 | Rating Cycle 1 Number of Health Revisits |
| Provider Information | Rating Cycle 1 Number of Standard Health Deficiencies | 6 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2025-04-09 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 24 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 6 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 7 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2021-11-17 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 36 | Rating Cycle 2/3 Health Deficiency Score |
| Provider Information | Rating Cycle 2/3 Health Revisit Score | 0 | Rating Cycle 2/3 Health Revisit Score |
| Provider Information | Rating Cycle 2/3 Number of Complaint Health Deficiencies | 2 | Rating Cycle 2/3 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 2/3 Number of Health Revisits | 1 | Rating Cycle 2/3 Number of Health Revisits |
| Provider Information | Rating Cycle 2/3 Total Health Score | 36 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 9 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.42601 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 40.0 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.83381 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 1.23628 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 1.95246 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.21769 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.59753 | Reported RN Staffing Hours per Resident per Day |
| Provider Information | Reported Staffing Footnote | — | Reported Staffing Footnote |
| Provider Information | Reported Total Nurse Staffing Hours per Resident per Day | 3.78627 | Reported Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Short-Stay QM Rating | 4 | Short-Stay QM Rating |
| Provider Information | Short-Stay QM Rating Footnote | — | Short-Stay QM Rating Footnote |
| Provider Information | Special Focus Status | — | Special Focus Status |
| Provider Information | Staffing Rating | 3 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | TN | State |
| Provider Information | Telephone Number | 9318643162 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 0.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 2.99278 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 0 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 45.2 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 27.000 | Total Weighted Health Survey Score |
| Provider Information | Urban | N | Urban |
| Provider Information | With a Resident and Family Council | Resident | With a Resident and Family Council |
| Provider Information | ZIP Code | 38549 | ZIP Code |