Map showing the location of SIGNATURE HEALTHCARE OF CLARKSVILLE in CLARKSVILLE, Tennessee
198 OLD FARMER ROAD, CLARKSVILLE, TN, 37043

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS 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 20% of peers298 rated homes · average 3.0★
  • Montgomery CountyLowest tier among peers5 rated homes · average 2.2★
  • United StatesAbove only 20% 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 star2★−0.5 vs TN avg
  • Quality measuresCan add or remove a star4★+0.5 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 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 assessments4★Above only 45% 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 staff4.05hrsAbove 76% 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 only0.68hrsAbove 72% 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 better81%Above only 1% of peersTN avg49%RN turnover81%
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$63,105Above only 14% of peersTN avg$28,854Fines · denials1 · 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
12citations
3inspection dates
0actual harm (G–I)
1immediate jeopardy (J–L)
May 28, 2025most recent

Citations by monthSep 2019 – May 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.

May 28, 20256 citationsCycle 1worst J · immediate jeopardy$63,105
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Jun 19, 2025
  2. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Jun 19, 2025
  3. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsD · isolatedCorrected Jun 19, 2025
  4. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jun 19, 2025
  5. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Jun 19, 2025
  6. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Jun 19, 2025
May 26, 20235 citationsCycle 3worst E · no actual harm
  1. F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Quality of Life and CareE · patternCorrected Jun 16, 2023
  2. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Jun 16, 2023
  3. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningE · patternCorrected Jun 16, 2023
  4. 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 PlanningE · patternCorrected Jun 16, 2023
  5. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareD · isolatedCorrected Jun 16, 2023
Sep 6, 20191 citationCycle 2worst D · no actual harm
  1. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceD · isolatedCorrected Oct 2, 2019

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined4.05hrsAbove 76% of peers+0.19 vs TN avg
  • Registered nursesRN hours only0.68hrsAbove 72% of peers+0.06 vs TN avg
  • Licensed practical nursesLPN hours1.26hrs
  • Nurse aidesCNA hours2.11hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.19hrs
  • Tennessee average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better81%Above only 1% of peersTN avg 49%
  • RN turnoverRegistered nurses only81%Not ranked by CMS
  • Administrators who leftIn the past year2Leadership changed
  • Occupancy120 certified beds · ~87 residents a day73%Above only 46% of peersTN avg 73%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $63,105In fines
  • 1Fine
  • 0Payment denials
  • $28,854TN avg in fines
Above only 14% of peersFewer fines than 14% of rated homes in Tennessee

Actions on record

  1. May 28, 2025Civil money penalty$63,105

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
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • LP Re I Holdings LLC
Indirect owners (5%+)
  • Jjla LLC
  • Lpsnf LLC
  • Shc LP Holdings II LLC
  • Spring Holdings, LLC
  • Wheaten LLC
  • Ira Smedra
  • Elmer Steier Iii
Corporate officers
  • John Harrison
Managing employees
  • Benjamin Crider

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 445448 · 198 OLD FARMER ROAD, CLARKSVILLE, TN, 37043.
  • Percentiles compare this facility with every rated nursing home in Tennessee and Montgomery 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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