Map showing the location of SIGNATURE HEALTHCARE OF ERIN in ERIN, Tennessee
278 ROCKY HOLLOW ROAD, ERIN, TN, 37061

Overall Score

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

Where it ranks

  • TennesseeLowest tier among peers298 rated homes · average 3.0★
  • United StatesLowest tier among peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs TN avg
  • StaffingCan add or remove a star2★−0.5 vs TN avg
  • Quality measuresCan add or remove a star2★−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.

  • Standard inspection overdueThe most recent standard health inspection is older than CMS expects, so the health inspection rating may not reflect current conditions.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among 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 turnover2★Above only 20% 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 assessments2★Above only 7% 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 staff3.63hrsAbove only 44% 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 only0.26hrsAbove only 2% 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 better44%Above 62% of peersTN avg49%RN turnover63%
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$210,753Above only 4% of peersTN avg$28,854Fines · denials2 · 0
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
11citations
4inspection dates
1actual harm (G–I)
4immediate jeopardy (J–L)
Apr 3, 2024most recent

Citations by monthApr 2019 – Apr 2024

  • 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.

Apr 3, 20244 citationsCycle 2worst K · immediate jeopardy$147,898
  1. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceK · patternCorrected Apr 8, 2024
  2. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceJ · isolatedCorrected Apr 8, 2024
  3. F602Protect each resident from the wrongful use of the resident's belongings or money.Freedom from Abuse, Neglect, and ExploitationK · patternCorrected Apr 8, 2024
  4. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareG · isolatedCorrected Apr 8, 2024
May 1, 20234 citationsCycle 3worst J · immediate jeopardy$62,855
  1. F741Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.Quality of Life and CareD · isolatedCorrected May 18, 2023
  2. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected May 18, 2023
  3. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected May 18, 2023
  4. 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 18, 2023
Mar 18, 20201 citationCycle 1worst D · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Apr 6, 2020
Apr 18, 20192 citationsCycle 2worst D · no actual harm
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Jun 1, 2019
  2. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Jun 1, 2019

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.63hrsAbove only 44% of peers−0.23 vs TN avg
  • Registered nursesRN hours only0.26hrsAbove only 2% of peers−0.36 vs TN avg
  • Licensed practical nursesLPN hours1.10hrs
  • Nurse aidesCNA hours2.27hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.15hrs
  • Tennessee average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better44%Above 62% of peersTN avg 49%
  • RN turnoverRegistered nurses only63%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy164 certified beds · ~104 residents a day63%Above only 28% of peersTN avg 73%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $210,753In fines
  • 2Fines
  • 0Payment denials
  • $28,854TN avg in fines
Above only 4% of peersFewer fines than 4% of rated homes in Tennessee

Actions on record

  1. Apr 3, 2024Civil money penalty$147,898
  2. May 1, 2023Civil money penalty$62,855

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Signature Healthcare71 facilities in the chain3.1★ 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%+)
  • LP Cr Holdings LLC
Indirect owners (5%+)
  • Agemo Holdings LLC
  • Jjla LLC
  • Lpsnf II LLC
  • Wheaten LLC
  • Ira Smedra
  • Elmer Steier Iii
Operational or managerial control
  • Signature Healthcare LLC
Corporate officers
  • John Harrison
Managing employees
  • Andrea Baston

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 445377 · 278 ROCKY HOLLOW ROAD, ERIN, TN, 37061.
  • Percentiles compare this facility with every rated nursing home in Tennessee and Houston 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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