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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 130th out of 130 homes in Alabama. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 45m per day | ▲ 18% State avg: 38m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 37m per day | ▼ 21% State avg: 47m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 1h 45m per day | ▼ 30% State avg: 2h 30m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 2h 33m per day | ▼ 22% State avg: 3h 17m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ■ Avg State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 27m per day | ▲ 23% State avg: 22m per day · National avg: 28m per day |
Higher than the Alabama average: 80.8%Cottage of the Shoals is administrated by David Grimes.
In Alabama, the Department of Public Health, Bureau of Health Provider Standards conducts unannounced surveys to ensure facilities meet state licensing and federal certification safety standards.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Alabama state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | AL Average | vs. AL Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 5 | 17 | This facility has 71% fewer total deficiencies than a typical Alabama nursing home (5 vs. AL avg 17).↓ 71% better |
|
Deficiencies per year
Average deficiencies per year since 2018.
| 0.6 | 2.1 | This facility has 71% fewer deficiencies per year than a typical Alabama nursing home (0.6 vs. AL avg 2.1).↓ 71% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
This facility’s inspection record is mixed, with repeated deficiencies in infection control, medical recordkeeping, and timely abuse reporting. On August 5, 2021, inspectors cited three deficiencies, including incomplete medical records and poor infection prevention during medication administration. Earlier complaints substantiated failures to report abuse promptly in 2018 and flagged hand hygiene lapses during medication administration in 2019, showing ongoing challenges in compliance.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsAlabama average 2.9
Last Health inspection on Aug 2021
Alabama average 10.4
Alabama average 3.46
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 5 citations resulted from standard inspections.
100% better than Alabama averageAlabama average: 0.7
100% better than Alabama averageAlabama average: 0.2
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
10% better than Alabama average
9% better than Alabama average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.4 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hoursThis role is partially covered by contractors.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,636 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 38 | 1 | 39 | 13,886 | 92 | 100% | 9.7 |
| Licensed Practical Nurse | 12 | 7 | 19 | 5,137 | 92 | 100% | 9.4 |
| Registered Nurse | 17 | 1 | 18 | 4,173 | 92 | 100% | 8.8 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 1,368 | 66 | 72% | 8 |
| Speech Language Pathologist | 3 | 0 | 3 | 1,222 | 75 | 82% | 7.3 |
| Physical Therapy Aide | 3 | 0 | 3 | 884 | 71 | 77% | 7.5 |
| Other Dietary Services Staff | 6 | 0 | 6 | 545 | 79 | 86% | 6.1 |
| Nurse Practitioner | 1 | 0 | 1 | 504 | 63 | 68% | 8 |
| Mental Health Service Worker | 1 | 0 | 1 | 480 | 60 | 65% | 8 |
| Administrator | 1 | 0 | 1 | 472 | 59 | 64% | 8 |
| RN Director of Nursing | 1 | 0 | 1 | 464 | 58 | 63% | 8 |
| Qualified Social Worker | 2 | 0 | 2 | 460 | 67 | 73% | 6.9 |
| Respiratory Therapy Technician | 2 | 0 | 2 | 261 | 55 | 60% | 4.7 |
| Medication Aide/Technician | 3 | 0 | 3 | 254 | 46 | 50% | 5.2 |
| Occupational Therapy Aide | 0 | 2 | 2 | 238 | 39 | 42% | 5.9 |
| Physical Therapy Assistant | 3 | 0 | 3 | 222 | 61 | 66% | 3.6 |
| Other Social Services Staff | 1 | 0 | 1 | 185 | 26 | 28% | 7.1 |
| Nurse Aide in Training | 2 | 0 | 2 | 85 | 10 | 11% | 8.5 |
| Occupational Therapy Assistant | 0 | 2 | 2 | 49 | 14 | 15% | 3.5 |
| Medical Director | 0 | 1 | 1 | 48 | 23 | 25% | 2.1 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
6.4
28% better than Alabama averageAlabama average: 8.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
9.4
35% better than Alabama averageAlabama average: 14.5
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
6.4%
54% better than Alabama averageAlabama average: 13.9%
Percent of long-stay residents whose ability to move independently worsened
8.6%
47% better than Alabama averageAlabama average: 16.1%
Percent of low risk long-stay residents who lose control of their bowels or bladder
13.1%
In line with Alabama averageAlabama average: 13.6%
Percent of long-stay residents experiencing one or more falls with major injury
3.7%
11% worse than Alabama averageAlabama average: 3.4%
Percent of long-stay high risk residents with pressure ulcers
5.1%
15% better than Alabama averageAlabama average: 5.9%
Percent of long-stay residents with a urinary tract infection
2.5%
9% better than Alabama averageAlabama average: 2.7%
Percent of long-stay residents who lose too much weight
8.1%
49% worse than Alabama averageAlabama average: 5.4%
Percent of long-stay residents who have depressive symptoms
6.7%
450% worse than Alabama averageAlabama average: 1.2%
Percent of long-stay residents who received an antipsychotic medication
6.4%
69% better than Alabama averageAlabama average: 20.7%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.3%
9% better than Alabama averageAlabama average: 91.5%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.8%
In line with Alabama averageAlabama average: 94.8%
Number of hospitalizations per 1,000 long-stay resident days.
1.18
41% better than Alabama averageAlabama average: 2.00
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.03
13% worse than Alabama averageAlabama average: 1.79
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
98.1%
17% better than Alabama averageAlabama average: 83.7%
Percent of short-stay residents who newly received an antipsychotic medication
0.7%
65% better than Alabama averageAlabama average: 2.1%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
96.4%
20% better than Alabama averageAlabama average: 80.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
18.6%
24% better than Alabama averageAlabama average: 24.5%
Percentage of short-stay residents who had an outpatient emergency department visit.
17.2%
50% worse than Alabama averageAlabama average: 11.5%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Alabama averageAlabama average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
43.4%
19% worse than Alabama averageAlabama average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
48.1%
5% worse than Alabama averageAlabama average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
31% of new residents, usually for short-term rehab.
56% of new residents, often for short stays.
13% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
66Residents meet regularly to discuss policies, care quality, and activities
Family members meet regularly to discuss policies, care quality, and activities
Organized group of family members that meets regularly to discuss facility policies, resident care, and activities.
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Cottage of the Shoals based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #51 / 129Payroll — State benchmarkedThis home is ranked 51st out of 129 homes in Alabama. Shows total annual staff payroll benchmarked to the Alabama average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
0.0 miles from city center
Estimated distance in miles from Tuscumbia's city center to Cottage of the Shoals's address, calculated via Google Maps.
Add your location
Cottage of the Shoals is located in Tuscumbia, Alabama.
Here are the financial assistance programs available to residents in Alabama.
The information below is reported by the Alabama Department of Public Health, Bureau of Health Provider Standards.
| Redstone Village |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Huntsville (Redstone Village) | 56 | 94.3% | +17% | 5.19 | -34% | +19% | $0 | 3 | 1.5 | - | 53 | 17 | Redstone Military Retirement Residence Association Inc | $23.8M | $10.6M | 44.4% | 15454 | ||||
| Aspire Physical Recovery Center Of West Alabama |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Northport (Dutton Place) | 75 | 93.8% | +16% | 4.31 | +4% | -1% | $0 | 6 | 3.0 | - | 72 | 51 | West Alabama Health Properties LLC | $10.9M | $4.5M | 41.3% | 15465 | ||||
| Cottage of the Shoals |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Tuscumbia | 103 | 85.2% | +5% | 2.64 | +56% | -39% | $0 | 5 | 1.7 | - | 86 | 65 | David Grimes | $12.3M | $5.9M | 47.8% | 15067 | ||||
| John Knox Manor – Retirement Community |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Montgomery (Seth Johnson Estates) | 98 | 58.2% | -28% | 5.02 | -29% | +15% | $0 | 4 | 2.0 | - | 61 | 34 | Terri Howell | $7.8M | $3.6M | 46.8% | 15135 | ||||
| Regency Retirement Village of Huntsville |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Huntsville (Greenhill) | 104 | 93.8% | +16% | 4.48 | -13% | +2% | $16.8k | 20 | 5.0 | 3 | 83 | 44 | Huntsville Senior Services LLC | $21.1M | $10.3M | 49% | 15372 |
Cottage of the Shoals has a walk score of 65. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
Cottage of the Shoals's occupancy is 85%.
David Grimes is the administrator of Cottage of the Shoals.
Cottage of the Shoals has 103 beds.
Cottage of the Shoals is located at 500 John Aldridge Drive.
(256) 383-4541 will put you in contact with the team at Cottage of the Shoals.
Cottage of the Shoals is in Colbert County.
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