Map showing the location of NHC HEALTHCARE, SMITHVILLE in SMITHVILLE, Tennessee
825 FISHER AVE, SMITHVILLE, TN, 37166

Overall Score

CMS Five-Star Quality Rating
3/5AverageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • TennesseeAbove only 40% of peers298 rated homes · average 3.0★
  • United StatesAbove only 41% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point2★−0.8 vs TN avg
  • StaffingCan add or remove a star3★+0.5 vs TN avg
  • Quality measuresCan add or remove a star5★+1.5 vs TN avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles2★Above only 17% of peersTN avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover3★Above 57% of peersTN avg2.5★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 69% of peersTN avg3.5★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.83hrsAbove 63% of peersTN avg3.86Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.51hrsAbove only 40% of peersTN avg0.62Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better48%Above 51% of peersTN avg49%RN turnover13%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$228,511Above only 3% of peersTN avg$28,854Fines · denials1 · 1
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
10citations
3inspection dates
1actual harm (G–I)
2immediate jeopardy (J–L)
Feb 27, 2025most recent

Citations by monthOct 2018 – Feb 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Feb 27, 20252 citationsCycle 1worst D · no actual harm
  1. F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.Resident Assessment and Care PlanningD · isolatedCorrected Mar 3, 2025
  2. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected Mar 12, 2025
Apr 11, 20247 citationsCycle 2worst K · immediate jeopardy$228,511, payment denial
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 30, 2024
  2. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningG · isolatedCorrected May 2, 2024
  3. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected May 2, 2024
  4. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesD · isolatedCorrected May 2, 2024
  5. F730Observe each nurse aide's job performance and give regular training.Nursing and Physician ServicesD · isolatedCorrected May 2, 2024
  6. F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationD · isolatedCorrected May 2, 2024
  7. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationK · patternCorrected Jun 19, 2024
Oct 31, 20181 citationCycle 3worst D · no actual harm
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Nov 30, 2018

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.83hrsAbove 63% of peers−0.03 vs TN avg
  • Registered nursesRN hours only0.51hrsAbove only 40% of peers−0.11 vs TN avg
  • Licensed practical nursesLPN hours0.83hrs
  • Nurse aidesCNA hours2.49hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.43hrs
  • Tennessee average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better48%Above 51% of peersTN avg 49%
  • RN turnoverRegistered nurses only13%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy114 certified beds · ~85 residents a day74%Above only 48% of peersTN avg 73%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $228,511In fines
  • 1Fine
  • 1Payment denial
  • $28,854TN avg in fines
Above only 3% of peersFewer fines than 3% of rated homes in Tennessee

Actions on record

  1. Apr 11, 2024Civil money penalty$228,511
  2. Apr 11, 2024Denial of payment for new admissionsfrom May 10, 2024

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
National Healthcare Corporation64 facilities in the chain3.9★ chain average
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Nhc-Op LP
Indirect owners (5%+)
  • Blackrock INC
  • Dimensional Fund Advisors LP
  • Morgan Stanley
  • National Health Corporation
  • National Healthcare Corporation
  • Vanguard Group INC
Operational or managerial control
  • National Healthcare Corporation
  • Nhc-Op LP
  • Gregory Bidwell
  • Vicki Dodson
  • Brian Kidd
  • Lori Panter
  • William Sherwood
  • Robert Ussery
  • +1 more
Corporate officers
  • Gregory Bidwell

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 445116 · 825 FISHER AVE, SMITHVILLE, TN, 37166.
  • Percentiles compare this facility with every rated nursing home in Tennessee and De Kalb County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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