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Signature Healthcare Of Putnam County
Nursing Home, Respite Care & Skilled Nursing · Cookeville, 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.

Signature Healthcare Of Putnam County

Nursing Home, Respite Care & Skilled Nursing · Cookeville, 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.
278 Dry Valley Road, Cookeville, TN 38506 View map Calculator: See prices in your area
Signature Healthcare Of Putnam County accepts Medicare, Medicaid, and private pay.
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Signature Healthcare Of Putnam County accepts Medicare, Medicaid, and private pay.

Overview of Signature Healthcare of Putnam County

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Delivering a full continuum of care since 1992, Signature Healthcare of Putnam County coordinates long-term skilled nursing, medical rehabilitation, and short-term respite stays within a 175-bed building. Administrator Paula Boone manages daily operations, which include multi-denominational chaplain programs, a beauty salon, private rooms, and an on-site physician. Payer distribution covers a varied mix, with 56% paying privately, 35% utilizing Medicare, and 9% relying on Medicaid. Residents record an average stay of 77 days, and the property maintains a 75.3% occupancy rate in a highly walkable city-center neighborhood carrying a Walk Score of 79.

State records point to thin staffing configurations, noting that daily nursing attention averages 3 hours and 7 minutes per resident to fall roughly 15% below the Tennessee benchmark. This reduction becomes more pronounced on weekends, when registered nurse coverage averages 13 minutes daily, marking a 46% drop below the state baseline. To balance these low nursing averages, the property’s dedicated physical therapy presence tracks 20% above the state standard, matching its focus on short-term recovery.

Operational data also reveals significant local financial friction, with the home reporting a net loss of $1.4 million in 2023 on total revenues of $19 million. On the clinical side, quality logs show strong preventive performance, including favorable vaccination updates and low rates of serious fall injuries, though resident anti-psychotic medication use runs higher than the state average.

Prospective residents weighing regional post-acute rehabilitation choices can look through these public health summaries to evaluate the facility’s day-to-day patterns. Since the official tracking profiles document solid physical therapy scores and positive long-term wellness indicators alongside below-average nursing hours and notable financial deficits, examining the facility’s clinical oversight and administrative stability is a helpful precaution.

Facility Direct Line (931) 537-6524
Facility Direct Line (931) 537-6524
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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.
▼ 64.7% Below TN avg. ▼ 64.7% Below TN avg.TN average: 2.8Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▼ 64.1% Below TN avg. ▼ 64.1% Below TN avg.TN average: 2.8Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▼ 17.2% Below TN avg. ▼ 17.2% Below TN avg.TN average: 2.4Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▲ 16.3% Above TN avg. ▲ 16.3% Above TN avg.TN average: 3.4Click the badge to see the full State ranking.Click here to see the full State ranking.

Staffing hours 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 vs Tennessee averages

Rank #129 / 179Nurse hours — State benchmarkedThis home is ranked 129th out of 179 homes we track in Tennessee for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Tennessee average, with a ranking across 179 Tennessee facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This home is ranked 129th out of 179 homes we track in Tennessee for nurse hours. 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.

3h 10m

13% below state avg
Staff type
Hours / day / resident
vs 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.
25m
−33% State avg: 37m per day · National avg: 41m 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.
51m
−21% State avg: 1h 5m per day · National avg: 52m 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.
1h 54m
−11% State avg: 2h 9m per day · National avg: 2h 20m 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.
2h 42m
−20% State avg: 3h 21m per day · National avg: 3h 26m 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.
7m
+32% State avg: 5m per day · National avg: 4m 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.
19m
−20% State avg: 24m per day · National avg: 28m per day

5 of 6 metrics below state avg

Standout metric: Physical Therapist is +32% above Tennessee average

Capacity and availability

Residents per day (avg)
139
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
77 days
Bed community size
175-bed community Rank #20 / 425Bed count — State benchmarkedThis home is ranked 20th out of 425 homes we track in Tennessee for bed count. 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.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A large-scale community that may provide a wide range of amenities, services, and structured programs.
Years in operation
34 years in operation Rank #48 / 386Years in operation — State benchmarkedThis home is ranked 48th out of 386 homes we track in Tennessee for years in operation. Shows how long this facility has been in operation compared to other Tennessee facilities. Longer operating histories may benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.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: 79 / 100 Rank #10 / 520Walk Score — State benchmarkedThis home is ranked 10th out of 520 homes we track in Tennessee for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Tennessee facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate
80%
Rank #117 / 268Occupancy rate — State benchmarkedThis home is ranked 117th out of 268 homes we track in Tennessee for occupancy. Shows this facility's occupancy rate versus the Tennessee average, with its Statewide rank out of 268. Higher occupancy signals strong local demand and financial stability.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Higher than the Tennessee average: 71.6%
Occupied beds
139 / 175
Average occupied beds in Tennessee homes 82 beds

License Details

Facility TypeNursing Home
IssuanceJuly 1, 1992
ExpirationOctober 1, 2027
License Number00000206
CMS Certification Number445136

Ownership & Operating Entity

Signature Healthcare Of Putnam County is administered by Paula Boone.

Owner NameLP Cookeville LLC

Therapy & Rehabilitation

3 services
Rehabilitation Services
Respite Care
Short-Term Rehab

Staffing & Medical

2 services
Doctor on Staff
24-Hour Staffing

Additional Policies & Features

Pets not allowed

Amenities & Lifestyle

Wi-Fi
Salon
Café
Religious Services
Private Room Available
Specific ProgramsClinical Services, Care Navigation, Volunteer Program
Religious Services
Volunteer Program
Touring HoursMonday-Friday: 9:00 AM - 9:00 PM, Saturday & Sunday: 10:00 AM - 6:30 PM

Contact Signature Healthcare Of Putnam County

CMS Health Inspection History

Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.

Inspections Since 2018 · 8 years of data
Total health inspections 3

State average 3.5

Last Health inspection on Apr 2025

Total health citations
14 Rank #85 / 180Health citations — State benchmarkedThis home is ranked 85th out of 180 homes we track in Tennessee for health citations. Shows this facility's total health deficiency citations benchmarked to the Tennessee State average, with a ranking across all 180 TN facilities. Lower citation counts earn a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average 15.4

Citations per inspection
4.67 Rank #106 / 180Citations per inspection — State benchmarkedThis home is ranked 106th out of 180 homes we track in Tennessee for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Tennessee mean across 180 facilities with citation data. Lower is better.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average 4.39

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

11 of 14 citations resulted from standard inspections; and 3 of 14 resulted from complaint investigations.

Breakdown of citation severity (last 8 years)
Critical health citations
0
100% better than State average

State average: 1.1

Serious health citations
0
100% better than State average

State average: 0.6

0 critical citations State average: 1.1
0 serious citations State average: 0.6
14 moderate citations State average: 13.7
0 minor citations State average: 0.1
Citations history (last 8 years)
Pharmacy moderate citation Apr 03, 2025
Corrected
Quality of Care moderate citation Apr 03, 2025
Corrected
Care Planning moderate citation Apr 03, 2025
Corrected
Nursing Services moderate citation May 18, 2023
Corrected

Data sourced from CMS Health Deficiencies reports, which cover the Medicare and/or Medicaid-certified skilled-nursing and nursing beds and no other part of the community. 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 175
Employees 170
Contractors 5
Staff to resident ratio 1.38 : 1
21% fewer staff per resident than Tennessee average
Tennessee average ratio: 1.75 : 1 Tennessee average ratio: 1.75 : 1See full Tennessee ranking
Avg staff/day 63
Average shift 9.1 hours
10% better than Tennessee average
Tennessee average: 8.3 hours Tennessee average shift: 8.3 hoursSee full Tennessee ranking
Total staff hours (quarter) 52,942

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 17 total: 16 full-time employees and 1 contractor. 17
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 10 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 33 LPN Staff are full-time employees. No contractors work on this role. 33
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.7 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 82 CNA Staff are full-time employees. No contractors work on this role. 82
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.6 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

0.3%

142 contractor hours this quarter

Occupational Therapy Assistant: 3 Registered Nurse: 1 Medical Director: 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 Assistant8208226,45092100%9.6
Licensed Practical Nurse3303310,81492100%9.7
Registered Nurse161174,11292100%10
Clinical Nurse Specialist7071,6416672%8.4
RN Director of Nursing3031,3816672%7.9
Respiratory Therapy Technician4041,3796672%7.9
Physical Therapy Assistant5051,1408390%6.5
Other Dietary Services Staff4041,0788289%7.9
Speech Language Pathologist3031,0127076%7.1
Physical Therapy Aide4048616672%6.7
Dental Services Staff1015976470%9.3
Dietitian1015406470%8.4
Nurse Practitioner1015246672%7.9
Qualified Social Worker2024976267%8
Administrator1014806065%8
Mental Health Service Worker3032994347%6.9
Occupational Therapy Assistant033933033%2.9
Medical Director011464145%1.1
82 Certified Nursing Assistant
% of Days 100%
33 Licensed Practical Nurse
% of Days 100%
17 Registered Nurse
% of Days 100%
7 Clinical Nurse Specialist
% of Days 72%
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. 10.6
In line with Tennessee average

Tennessee average: 10.5

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 19.3
In line with Tennessee average

Tennessee average: 19.5

Long-stay resident measures
Above average Tennessee avg: 3.7 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 17.1%
7% worse than Tennessee average

Tennessee average: 16.0%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 22.4%
In line with Tennessee average

Tennessee 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 18.4%
11% better than Tennessee average

Tennessee average: 20.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 2.4%
34% better than Tennessee average

Tennessee average: 3.7%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 5.6%
In line with Tennessee average

Tennessee average: 5.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 2.2%
8% worse than Tennessee average

Tennessee average: 2.1%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 5.2%
17% better than Tennessee average

Tennessee average: 6.3%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 2.2%
80% better than Tennessee average

Tennessee average: 11.0%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 20.8%
26% worse than Tennessee average

Tennessee average: 16.5%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 95.2%
6% better than Tennessee average

Tennessee average: 89.9%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 95.9%
In line with Tennessee average

Tennessee average: 94.5%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.14
28% better than Tennessee average

Tennessee average: 1.58

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 0.38
76% better than Tennessee average

Tennessee average: 1.57

Short-stay resident measures
Average Tennessee avg: 3.4 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 86.8%
9% better than Tennessee average

Tennessee average: 79.7%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.4%
75% better than Tennessee average

Tennessee average: 1.7%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 86.9%
9% better than Tennessee average

Tennessee average: 79.8%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 23.0%
In line with Tennessee average

Tennessee average: 22.2%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 5.4%
52% better than Tennessee average

Tennessee average: 11.2%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.6%
19% better than Tennessee average

Tennessee average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 52.1%
In line with Tennessee average

Tennessee average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 48.1%
5% worse than Tennessee average

Tennessee average: 50.6%

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

Breakdown by payment type

Medicare

35% of new residents, usually for short-term rehab.

Typical stay 29 days

Private pay

56% of new residents, often for short stays.

Typical stay 1 - 2 months

Medicaid

9% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Facility Characteristics

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

Total residents 127
Medicare
17
13.4% of residents
Medicaid
81
63.8% of residents
Private pay or other
29
22.8% of residents
Programs & Services
Residents Group

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

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 12/2023.

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."
$15.8M
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."
-$2.2M
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."
$15.8M Rank #32 / 174Net patient revenue — State benchmarkedThis home is ranked 32nd out of 174 homes we track in Tennessee. Shows this facility's net patient revenue compared to the Tennessee average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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."
-$2.2M
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.
$821.7K
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 #74 / 174Payroll costs — State benchmarkedThis home is ranked 74th out of 174 homes we track in Tennessee. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Tennessee average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
$5.7M 36.1% 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 #171 / 174Payroll % of net patient revenue — State benchmarkedThis home is ranked 171st out of 174 homes we track in Tennessee. Shows payroll as a percentage of net patient revenue versus the Tennessee average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Tennessee that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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).
$12.3M
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).
$18.0M
How we calculate these figures

This home is administered by Paula Boone.

This home is owned by Paula Boone

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 445136

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.

Most new residents arrive under private pay (56% of admissions), and a typical private pay stay runs around 1 - 2 months.

Admissions
632 total

Coverage residents most often arrive under.

Medicare 35%
Private pay 56%
Medicaid 9%
Discharges
623 total

Coverage residents most often leave under.

Medicare 28%
Private pay 55%
Medicaid 17%

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

How we assess these insights

Places of interest near Signature Healthcare Of Putnam County

Address 0.0 miles from city center Info Estimated distance in miles from Cookeville's city center to Signature Healthcare Of Putnam County's address, calculated via Google Maps.

Calculate Travel Distance to Signature Healthcare Of Putnam County

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Address

Compare Nursing Homes around the area

Info below is compiled from CMS reports & the TN Dept. of Health (TDH), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table AL (Assisted Living): Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing. NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia. RC (Respite Care): Short-term temporary care that gives family caregivers a break. IL (Independent Living): Community living with dining, activities, and transportation for active seniors who need little personal care. HC (Home Care): Professional care delivered in the person's own home, from companionship to skilled nursing. HOS (Hospice Care): Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Tennessee average is: 54.1% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
Trezevant ★ ★ ★ ★ ★
NH
AL
IL
MC
SNF
Memphis (Waynoka)
104
Facility 104
TN AVG 88
Rank #132 / 425
--
6.24
Facility 6.24
TN AVG 3.63
Rank #4 / 179
 ★ ★ ★ ★ ★ ★ ★ ★ ★ ☆ ★ ★ ★ ☆ ☆ +66%+72%
$0
Facility $0
TN AVG $90.9k
Rank #1 / 181
3
Facility 3
TN AVG 15.4
Rank #10 / 180
1.5
Facility 1.5
TN AVG 4.4
Rank #5 / 180
-13A+
29
Facility 29
TN AVG 36
Rank #317 / 520
Paul Martin
$11.8MFiscal year ending 07/2024
Facility $11.8MFiscal year ending 07/2024
TN AVG $11.1M
Rank #57 / 174
$17.3MFiscal year ending 07/2024
Facility $17.3MFiscal year ending 07/2024
TN AVG $5.9M
Rank #2 / 174
146.9%Fiscal year ending 07/2024
Facility 146.9%Fiscal year ending 07/2024
TN AVG 54.1%
Rank #3 / 174
445133
NHC HealthCare Johnson City ★ ★ ★ ★ ★
NH
HC
HOS
SNF
Johnson City
10
Facility 10
TN AVG 88
Rank #425 / 425
100.0%
Facility 100.0%
TN AVG 73.1%
Rank #1 / 268
+37%
3.58
Facility 3.58
TN AVG 3.63
Rank #73 / 179
 ★ ★ ★ ★ ★ ★ ★ ★ ☆ ☆ ★ ★ ★ ★ ★ -8%-1%
$0
Facility $0
TN AVG $90.9k
Rank #1 / 181
3
Facility 3
TN AVG 15.4
Rank #10 / 180
1.5
Facility 1.5
TN AVG 4.4
Rank #5 / 180
-10-
2
Facility 2
TN AVG 36
Rank #507 / 520
Howard Nason Jr.
$19.1MFiscal year ending 12/2023
Facility $19.1MFiscal year ending 12/2023
TN AVG $11.1M
Rank #13 / 174
$10.6MFiscal year ending 12/2023
Facility $10.6MFiscal year ending 12/2023
TN AVG $5.9M
Rank #15 / 174
55.7%Fiscal year ending 12/2023
Facility 55.7%Fiscal year ending 12/2023
TN AVG 54.1%
Rank #60 / 174
445024
West Meade Place LLP ★ ★ ★ ★ ★
NH
SNF
Nashville (West Meade)
120
Facility 120
TN AVG 88
Rank #81 / 425
84.8%
Facility 84.8%
TN AVG 73.1%
Rank #81 / 268
+16%
2.91
Facility 2.91
TN AVG 3.63
Rank #161 / 179
 ★ ★ ★ ★ ☆ ★ ★ ☆ ☆ ☆ ★ ★ ★ ★ ★ +57%-20%
$0
Facility $0
TN AVG $90.9k
Rank #1 / 181
16
Facility 16
TN AVG 15.4
Rank #98 / 180
5.3
Facility 5.3
TN AVG 4.4
Rank #131 / 180
-102A+
54
Facility 54
TN AVG 36
Rank #99 / 520
Barbara Friedbauer
$16.1MFiscal year ending 12/2023
Facility $16.1MFiscal year ending 12/2023
TN AVG $11.1M
Rank #31 / 174
$10.3MFiscal year ending 12/2023
Facility $10.3MFiscal year ending 12/2023
TN AVG $5.9M
Rank #16 / 174
64.2%Fiscal year ending 12/2023
Facility 64.2%Fiscal year ending 12/2023
TN AVG 54.1%
Rank #22 / 174
445203
Ivy Hall Nursing Home ★ ★ ★ ★ ★
NH
RC
SNF
Elizabethton
101
Facility 101
TN AVG 88
Rank #139 / 425
83.5%
Facility 83.5%
TN AVG 73.1%
Rank #88 / 268
+14%
3.97
Facility 3.97
TN AVG 3.63
Rank #34 / 179
 ★ ★ ★ ★ ★ ★ ★ ★ ★ ☆ ★ ★ ★ ★ ☆ -10%+9%
$0
Facility $0
TN AVG $90.9k
Rank #1 / 181
2
Facility 2
TN AVG 15.4
Rank #1 / 180
2.0
Facility 2.0
TN AVG 4.4
Rank #12 / 180
-84-
68
Facility 68
TN AVG 36
Rank #37 / 520
Judy Deloach
$9.3MFiscal year ending 12/2023
Facility $9.3MFiscal year ending 12/2023
TN AVG $11.1M
Rank #96 / 174
$5.6MFiscal year ending 12/2023
Facility $5.6MFiscal year ending 12/2023
TN AVG $5.9M
Rank #79 / 174
59.8%Fiscal year ending 12/2023
Facility 59.8%Fiscal year ending 12/2023
TN AVG 54.1%
Rank #42 / 174
445469
Signature Healthcare Of Putnam County ★ ☆ ☆ ☆ ☆
NH
RC
SNF
Cookeville (West Side)
175
Facility 175
TN AVG 88
Rank #20 / 425
79.7%
Facility 79.7%
TN AVG 73.1%
Rank #117 / 268
+9%
3.17
Facility 3.17
TN AVG 3.63
Rank #129 / 179
 ★ ☆ ☆ ☆ ☆ ★ ★ ☆ ☆ ☆ ★ ★ ★ ★ ☆ +10%-13%
$0
Facility $0
TN AVG $90.9k
Rank #1 / 181
14
Facility 14
TN AVG 15.4
Rank #85 / 180
4.7
Facility 4.7
TN AVG 4.4
Rank #106 / 180
-139-
79
Facility 79
TN AVG 36
Rank #10 / 520
Paula Boone
$15.8MFiscal year ending 12/2023
Facility $15.8MFiscal year ending 12/2023
TN AVG $11.1M
Rank #32 / 174
$5.7MFiscal year ending 12/2023
Facility $5.7MFiscal year ending 12/2023
TN AVG $5.9M
Rank #74 / 174
36.1%Fiscal year ending 12/2023
Facility 36.1%Fiscal year ending 12/2023
TN AVG 54.1%
Rank #171 / 174
445136
Nursing Home Explorer

Frequently Asked Questions about Signature Healthcare Of Putnam County

What neighborhood is Signature Healthcare Of Putnam County in?

Signature Healthcare Of Putnam County is in the West Side neighborhood of Cookeville.

Who is the owner of Signature Healthcare Of Putnam County?

Signature Healthcare Of Putnam County is legally operated by LP Cookeville LLC, and administered by Paula Boone.

Is Signature Healthcare Of Putnam County in a walkable area?

Signature Healthcare Of Putnam County has a walk score of 79. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the license number of Signature Healthcare Of Putnam County?

According to TN state health department records, Signature Healthcare Of Putnam County's license number is 00000206.

When does Signature Healthcare Of Putnam County's license expire?

According to TN state health department records, Signature Healthcare Of Putnam County's license expires on October 1, 2027.

What is the occupancy rate at Signature Healthcare Of Putnam County?

Signature Healthcare Of Putnam County's occupancy is 80%.

How long has Signature Healthcare Of Putnam County been in business?

Signature Healthcare Of Putnam County has been operating for approximately 34 years, based on available licensing and registration records.

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