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The Waters of Gainesboro
Nursing Home, Assisted Living & Respite Care · Gainesboro, TN
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.

The Waters of Gainesboro

Nursing Home, Assisted Living & Respite Care · Gainesboro, TN
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1340 North Grundy Quarles Highway, Gainesboro, TN 38562 View map Calculator: See prices in your area
The Waters of Gainesboro accepts Medicaid, Medicare, and private pay.
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The Waters of Gainesboro accepts Medicaid, Medicare, and private pay.

Overview of The Waters of Gainesboro

Serving residents across Jackson County, The Waters of Gainesboro provides skilled nursing care, memory care, short-term rehabilitation, and respite care in a rural Tennessee setting. The facility is an 83-bed nursing home in Gainesboro, operated by The Waters of Gainesboro, LLC, under the administration of Rita Crabtree. Medicare and Medicaid are both accepted.

The CMS 3-star overall rating reflects a marked split across sub-ratings. Health Inspection performance is 37% above the Tennessee average, a meaningful positive signal for families weighing recent compliance history. However, staffing is the counterweight. Total nurse staffing averages 2 hours and 57 minutes per resident per day, compared with a state average of 3 hours and 40 minutes, placing the facility 150th out of 172 Tennessee SNFs on that measure.

Over five inspections since 2017, the facility has received 16 citations. A 2019 annual survey produced an Immediate Jeopardy finding related to elopement prevention. A February 2023 complaint investigation substantiated a failure to report an allegation of abuse within the required two-hour window. No fines or enforcement actions appear in the available reports.

Occupancy sits at 54%, well below the Tennessee average of 73%, which typically indicates current availability. Clinical programs include Comprehensive Wound Care and Respiratory Services, as well as the Living Well and In Motion activity and wellness tracks.

The facility serves residents requiring post-acute rehabilitation, long-term skilled nursing, or memory care support in rural Jackson County, Tennessee.

Facility Direct Line (931) 268-0291
Facility Direct Line (931) 268-0291 admin@watersofgainesboro.com

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
Health Inspection Info 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.
Staffing Info 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.
Quality Measures Info 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.

Staffing hours breakdown

Info 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.

Hours per resident per day — compared to state averages

Total nursing care / resident Info 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.
2h 57m per day
Rank #169 / 192Nurse hours — State benchmarkedThis home is ranked 169th out of 192 homes in Tennessee. Shows adjusted nurse hours per resident per day benchmarked to the Tennessee average, with a ranking across 192 Tennessee facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs avg
Staff typeHours / Day / Residentvs state avg
Registered Nurse (RN) Info 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. 21m per day
LPN / LVN Info 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. 1h 8m per day
Nurse Aide Info 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. 2h 7m per day
Weekend Total Nursing Info 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. 3h 28m per day
Physical Therapist Info 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
Weekend RN Info 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. 17m per day

Capacity and availability

Avg. Length of Stay
175 days
Bed community size
83-bed community Rank #199 / 426Bed count — State benchmarkedThis home is ranked 199th out of 426 homes in Tennessee. Shows this facility's certified or reported bed count compared to other Tennessee facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A larger shared setting that may offer more common spaces and organized community services.
Years in operation
33 years in operation Rank #67 / 385Years in operation — State benchmarkedThis home is ranked 67th out of 385 homes in Tennessee. Shows how long this facility has been in operation compared to other Tennessee facilities. Longer operating histories may benefit residents, families, and staff.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
Walk Score
Walk Score: 41 / 100 Rank #215 / 553Walk Score — State benchmarkedThis home is ranked 215th out of 553 homes in Tennessee. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Tennessee facilities. Higher scores benefit residents, families, and staff.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

About this community

Occupancy

Occupancy rate
54%
Rank #268 / 319Occupancy rate — State benchmarkedThis home is ranked 268th out of 319 homes in Tennessee. Shows this facility's occupancy rate versus the Tennessee average, with its Statewide rank out of 319. Higher occupancy signals strong local demand and financial stability.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Lower than the Tennessee average: 71.6%
Occupied beds
45 / 83
Average occupied beds in Tennessee homes 82 beds

License Details

Facility TypeNursing Home
StatusLicensed
IssuanceJuly 1, 1992
License Number00000136
CMS Certification Number445171

Ownership & Operating Entity

The Waters of Gainesboro is administered by Rita Crabtree.

Owner NameThe Waters Of Gainesboro, LLC

Payment & Insurance

2 services
Accept Medicaid
Accept Medicare

Therapy & Rehabilitation

2 services
Rehabilitation Services
Respite Care

Amenities & Lifestyle

Specific ProgramsLiving Well, In Motion, Comprehensive Wound Care, Respiratory Services
Operating Hours24 hours - 7 days a week

Contact The Waters of Gainesboro

Inspection History

In Tennessee, the Department of Health, Division of Health Care Facilities performs unannounced inspections and investigations to ensure facilities provide high-quality resident care.

Since 2017 · 9 years of data 16 citations

Inspection Scorecard Info This scorecard compares key inspection, citation, and complaint metrics at this facility against the Tennessee state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2017 vs. Tennessee state average
Overall vs. TN average 2 Worse Metrics worse than Tennessee average:
• Total citations (300% above)
• Citations per year (350% above) 0 Better No metrics in this bucket.
Latest Inspection March 18, 2020

Citations Info Citations are formal regulatory issues recorded during state inspections.

This FacilityTN Averagevs. TN Avg
Total citations Info Formal regulatory issues recorded by inspectors across all inspection types. 164 This facility has 300% more total citations than a typical Tennessee assisted living residence (16 vs. TN avg 4).↑ 300% worse
Citations per year Info Average citations per year since 2017. 1.80.4 This facility has 350% more citations per year than a typical Tennessee assisted living residence (1.8 vs. TN avg 0.4).↑ 350% worse

Inspection Reports Summary Info An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

  • November 29, 2023 inspection found 2 deficiencies involving improper oxygen administration and unsafe respiratory equipment storage for Residents #3 and #4.
  • February 8, 2023 complaint investigation confirmed failure to report abuse allegations within the required 2-hour timeframe for Resident #3.
  • November 6, 2019 annual inspection cited immediate jeopardy for failure to prevent elopement and multiple care and food safety deficiencies.
Show Inspection Reports

Health Inspection History

Inspections since 2019
Total health inspections 4

State average N/A

Last Health inspection on Feb 2025

Total health citations
7 Rank #34 / 196Health citations — State benchmarkedThis home is ranked 34th out of 196 homes in Tennessee. Shows this facility's total health deficiency citations benchmarked to the Tennessee State average, with a ranking across all 196 TN facilities. Lower citation counts earn a better rank.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Citations per inspection
1.75 Rank #12 / 196Citations per inspection — State benchmarkedThis home is ranked 12th out of 196 homes in Tennessee. Shows average deficiency citations per CMS inspection for this facility versus the Tennessee mean across 196 facilities with citation data. Lower is better.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

6 of 7 citations resulted from standard inspections; and 1 of 7 resulted from complaint investigations.

Breakdown of citation severity (last 7 years)
Critical health citations
0
In line with State average

State average: N/A

Serious health citations
0
In line with State average

State average: N/A

0 critical citations State average: N/A
0 serious citations State average: N/A
7 moderate citations State average: N/A
0 minor citations State average: N/A
Citations history (last 7 years)
Nutrition moderate citation Feb 05, 2025
Corrected
Pharmacy moderate citation Feb 05, 2025
Corrected
Quality of Care moderate citation Feb 05, 2025
Corrected
Care Planning moderate citation Sep 01, 2023
Corrected

Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 77
Employees 63
Contractors 14
Staff to resident ratio 1.48 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 31
Average shift 8.7 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 24,695

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info All 2 RN Staff are full-time employees. No contractors work on this role. 2
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 11.3 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 17 LPN Staff are full-time employees. No contractors work on this role. 17
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.5 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 34 CNA Staff are full-time employees. No contractors work on this role. 34
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.2 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

4.8%

1,180 contractor hours this quarter

Physical Therapy Aide: 5 Physical Therapy Assistant: 4 Speech Language Pathologist: 2 Respiratory Therapy Technician: 2 Qualified Social Worker: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant3403412,56092100%9.2
Licensed Practical Nurse170176,76392100%9.5
Clinical Nurse Specialist3031,0617480%7.7
Other Dietary Services Staff3037568087%6.6
Dietitian1015456874%8
Nurse Practitioner1015426470%8.5
Registered Nurse2025163740%11.3
Mental Health Service Worker1014205661%7.5
Speech Language Pathologist0223836166%6.1
Administrator1013534549%7.8
Physical Therapy Aide0553064953%6.3
Physical Therapy Assistant0442525054%4.9
Respiratory Therapy Technician0221935459%3.6
Qualified Social Worker011471921%2.5
34 Certified Nursing Assistant
% of Days 100%
17 Licensed Practical Nurse
% of Days 100%
3 Clinical Nurse Specialist
% of Days 80%
3 Other Dietary Services Staff
% of Days 87%
1 Dietitian
% of Days 74%
1 Nurse Practitioner
% of Days 70%
2 Registered Nurse
% of Days 40%
1 Mental Health Service Worker
% of Days 61%
2 Speech Language Pathologist
% of Days 66%
1 Administrator
% of Days 49%
5 Physical Therapy Aide
% of Days 53%
4 Physical Therapy Assistant
% of Days 54%
2 Respiratory Therapy Technician
% of Days 59%
1 Qualified Social Worker
% of Days 21%
View All Staffing Data

Penalties and fines

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.

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 11.5
10% worse than State average

State average: 10.5

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 17.2
12% better than State average

State average: 19.5

Long-stay resident measures
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 10.2%
36% better than State average

State average: 16.0%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 18.4%
15% better than State average

State average: 21.7%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 23.1%
11% worse than State average

State average: 20.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 9.2%
150% worse than State average

State average: 3.7%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 5.4%
In line with State average

State average: 5.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 1.3%
35% better than State average

State average: 2.1%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 14.3%
127% worse than State average

State average: 6.3%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 27.0%
145% worse than State average

State average: 11.0%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 18.5%
12% worse than State average

State average: 16.5%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 96.7%
8% better than State average

State average: 89.9%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
6% better than State average

State average: 94.5%

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 91.1%
14% better than State average

State average: 79.7%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.9%
48% better than State average

State average: 1.7%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 79.0%
In line with State average

State average: 79.8%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

Breakdown by payment type

Medicare

49% of new residents, usually for short-term rehab.

Typical stay 9 - 10 months

Private pay

5% of new residents, often for short stays.

Typical stay 1 - 2 years

Medicaid

45% of new residents, often for long-term daily care.

Typical stay 2 - 3 months

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 52
Medicare
7
13.5% of residents
Medicaid
31
59.6% of residents
Private pay or other
14
26.9% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

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.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2022.

For-profit
Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$5.5M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$1.2M
For-profit Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$5.5M Rank #179 / 196Revenue — State benchmarkedThis home is ranked 179th out of 196 homes in Tennessee. Shows this facility's annual revenue compared to the Tennessee average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$1.2M
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$750.2K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #167 / 196Payroll — State benchmarkedThis home is ranked 167th out of 196 homes in Tennessee. Shows total annual staff payroll benchmarked to the Tennessee average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$3.3M 60.3% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #50 / 196Payroll % — State benchmarkedThis home is ranked 50th out of 196 homes in Tennessee. Shows payroll as a percentage of revenue versus the Tennessee average. Well-run Tennessee facilities typically land around 50–60% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Tennessee that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$3.4M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$6.7M
How we calculate these figures

This home is administered by Rita Crabtree.

This home is owned by The Waters Of Gainesboro, LLC

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 445272

Show certification details

Who this home usually serves

TYPE OF STAY

Mix of rehab and long-term care

This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.

New residents most often arrive under Medicare (49% of admissions), and a typical Medicare stay runs around 9 - 10 months.

Admissions
99 total

Coverage residents most often arrive under.

Medicare 49%
Private pay 5%
Medicaid 45%
Discharges
112 total

Coverage residents most often leave under.

Medicare 55%
Private pay 4%
Medicaid 40%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

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Nursing Home Explorer

Frequently Asked Questions about The Waters of Gainesboro

Is The Waters of Gainesboro in a walkable area?

The Waters of Gainesboro has a walk score of 41. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

What is the license number of The Waters of Gainesboro?

According to TN state health department records, The Waters of Gainesboro's license number is 00000136.

What is the occupancy rate at The Waters of Gainesboro?

The Waters of Gainesboro's occupancy is 54%.

Does The Waters of Gainesboro operate as a for-profit or non-profit?

The Waters of Gainesboro is registered as a for-profit in TN.

Who is the administrator of The Waters of Gainesboro?

Rita Crabtree is the administrator of The Waters of Gainesboro.

How many beds does The Waters of Gainesboro have?

The Waters of Gainesboro has 83 beds.

What is the address of The Waters of Gainesboro?

The Waters of Gainesboro is located at 1340 North Grundy Quarles Highway, Gainesboro, TN 38562.

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