Village at Cook Springs Skilled Nursing Facility

Village at Cook Springs Skilled Nursing Facility is a 168-bed skilled nursing facility at 415 Cook Springs Road in Pell City, Alabama, in St. Clair County. A voluntary non-profit organization administered by Randolph Pickell under Gregory Flippo’s ownership, it holds CMS Certification and accepts Medicare, Medicaid, and private pay. It attracts a heavily private-pay mix for a non-profit SNF: 47 percent of admissions are private pay with typical stays of two to three months, Medicaid accounts for 30 percent with stays of nine to ten months, and Medicare covers 23 percent with short stays averaging 18 days. The January 2026 census of 91 residents reflects a 73.8 percent occupancy rate, below the Alabama average of 80.8 percent. The facility is also part of a larger Continuing Care Retirement Community on a 200-plus-acre campus, which features walking trails, serene country views, apartment homes, and all-inclusive independent living suites that distinguish its setting from conventional nursing homes in the region.

The inspection record is the primary driver of the 1-star rating. Across 4 surveys in August 2018, July 2019, May 2022, and December 2023, the facility accumulated 12 citations at 4.0 per inspection, above the 3.46 Alabama average. The most significant finding is 3 critical citations over the eight-year window, 329 percent above the 0.7 Alabama average, a figure that places the facility well outside the norm on severity. Two of those critical citations emerged from the July 2019 survey in the Abuse, Neglect, and Exploitation category (one critical, one moderate). The December 2023 survey cited Infection Control and Quality of Care, both moderate and corrected. No fines or penalties have been issued in the past three years, which is a meaningful indicator that more recent performance has not triggered federal enforcement. CMS rates the facility the lowest tier of 1 star overall, fueled by a weak health inspection rating (65.0 percent below Alabama average) and below-average quality measures (32.2 percent below). The staffing dimension is an upside, rating 11.1 percent above average. Total adjusted nursing hours reach 4 hours 41 minutes per resident per day, ranking 37th of 121 Alabama SNFs, with CNA hours of 2 hours 43 minutes per day running 9 percent above the state benchmark. RN hours (32 minutes, −16 percent vs. state) and LPN hours (42 minutes, −11 percent vs state) are both below average, and weekend RN coverage at 16 minutes is 27 percent below the 22 minutes state average. Q2 2025 staffing data shows 196 total staff, 164 employees, and 32 contractors (4.4 percent contractor hours), with a headline staff-to-resident ratio of 2.15:1, though this figure is inflated by the multi-level CCRC campus structure and shouldn’t be read as a pure SNF staffing metric. Quality measure outcomes for long-stay residents present a mixed picture. Composite clinical scores are modestly better than the Alabama average, and ADL decline, walking decline, incontinence, and pressure ulcer rates all outperform state benchmarks. UTI rates, however, are 109 percent above the Alabama average (5.7 percent vs. 2.7 percent), the most significant clinical quality gap in the profile. Falls with major injury run 27 percent above average. For short-stay residents, zero falls with major injury and in-line return-to-community rates are positive, but re-hospitalization (27.4 percent vs. 24.5 percent) and new antipsychotic medication initiation (3.5 percent vs 2.1 percent) are both above average. Both pneumococcal and influenza vaccination rates reach 100 percent for long-stay residents. Financially, the facility is stable: $14.7 million in annual revenue, a $958,000 operating surplus, and payroll at 50.2 percent of revenue, slightly below the 54–69 percent benchmark range for well-run Alabama SNFs, though consistent with a multi-level CCRC where some staff serve non-SNF campus residents.

Amenities include a chapel with daily services, a library, a beauty and barbershop, public Wi-Fi, and a full calendar of social, cultural, and educational programming.

Village at Cook Springs may fit families needing a campus-style non-profit CCRC environment with nature access, above-average CNA staffing, and a broad continuum of care on one site. The 1-star CMS rating, three critical citations particularly Abuse/Neglect findings from 2019, and the elevated UTI rate are crucial concerns that families should address with facility leadership before placement. Reviewing the full inspection reports through CMS Care Compare is strongly recommended.

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