Four Oaks Health Care Center
1101 Persimmon Ridge Rd, Jonesborough, TN 37659 · Washington County · 84 certified beds · avg 60 residents/day · certified since Jul 1, 2002
Part of chain: AHAVA HEALTHCARE (16 facilities, chain avg rating 2.4★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
All citations in the current public record (10)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Dec 3, 2025 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. |
| Dec 3, 2025 | D · Potential for harm, one-off | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. |
| Mar 5, 2025 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Sep 8, 2023 | D · Potential for harm, one-off | The facility did not honor residents' right to share a room with their spouse or a roommate of their choosing, or moved residents to a different room without written notice beforehand. · from a complaint |
| Sep 8, 2023 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Feb 23, 2023 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Feb 23, 2023 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Feb 23, 2023 | D · Potential for harm, one-off | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| Feb 23, 2023 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Feb 23, 2023 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (5 → 2).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 7 | 0 | E |
| 2025 | 3 | 0 | D |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Tennessee avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.37 | 3.62 | 3.95 | bottom 40% in Tennessee; bottom 30% in the U.S. |
| Registered Nurse hours | 0.29 | 0.57 | 0.69 | bottom 9% in Tennessee; bottom 9% in the U.S. |
| Weekend total nurse staffing | 2.87 | 3.15 | 3.50 | bottom 38% in Tennessee; bottom 24% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.23 | 0.39 | 0.48 | bottom 20% in Tennessee; bottom 18% in the U.S. |
| Total nursing staff turnover (%) | 68.1 | 48.9 | 45.8 | bottom 6% in Tennessee; bottom 7% in the U.S. |
| RN turnover (%) | 85.7 | 43.2 | 42.9 | bottom 3% in Tennessee; bottom 3% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.47, RN 0.30, weekend 2.96. Staffing rating: 1/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Labin, Shiya | Individual | 5% or Greater Direct Ownership Interest | 8% | 04/28/2017 |
| McE Associates LLC | Organization | 5% or Greater Direct Ownership Interest | 10% | 04/28/2017 |
| Neuman, Benjamin | Individual | 5% or Greater Direct Ownership Interest | 10% | 04/28/2017 |
| Niederman, Anshel | Individual | 5% or Greater Direct Ownership Interest | 30% | 04/28/2017 |
| Edwards, Tammy | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/13/2022 |
| Edwards, Tammy | Individual | ADP of the SNF | NOT APPLICABLE | 03/27/2025 |
| Eisen, Menashe | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/27/2025 |
| Niederman, Anshel | Individual | Managing Control - Governing Body | NOT APPLICABLE | 06/01/2019 |
| Niederman, Anshel | Individual | Corporate Officer | NOT APPLICABLE | 04/28/2017 |
| Philipson, Bent | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/27/2025 |
| Philipson, Gabrielle | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/27/2025 |
| Philipson, Raquel | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/27/2025 |
| Rosenhein, Brian | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/13/2022 |
| Rosenhein, Brian | Individual | ADP of the SNF | NOT APPLICABLE | 04/07/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "How do you handle room assignments and roommate requests, and do residents get advance written notice before any move?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you record and honor each resident's treatment wishes and advance directives, and how do staff know about them?"
- "What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Lakebridge, a Waters Community, LLC | 5.3 mi | Johnson City, TN | ★★★☆☆ | 4/5 | |
| The Waters of Johnson City, LLC | 6.1 mi | Johnson City, TN | ★★☆☆☆ | 3/5 | |
| Agape Rehabilitation & Nursing Center, a Waters CM | 7.4 mi | Johnson City, TN | ★★★★☆ | 4/5 | |
| Abundant Christian Living Community Rehabilitation | 7.5 mi | Johnson City, TN | ★★★★★ | 5/5 | |
| Princeton Transitional Care & Assisted Living | 7.9 mi | Johnson City, TN | ★★★★★ | 5/5 | |
| NHC Healthcare, Johnson City | 8.0 mi | Johnson City, TN | ★★★★★ | 5/5 | |
| Life Care Center of Gray | 8.4 mi | Gray, TN | ★☆☆☆☆ | 1/5 | |
| Christian Care Center of Unicoi County | 11.7 mi | Erwin, TN | ★★★★☆ | 4/5 | |
| Center on Aging and Health | 11.8 mi | Erwin, TN | ★★★☆☆ | 3/5 | |
| Erwin Health Care Center | 11.9 mi | Erwin, TN | ★★☆☆☆ | 2/5 | |
| Durham-Hensley Health and Rehabilitation | 11.9 mi | Chuckey, TN | ★★★★☆ | 4/5 | |
| Greystone Health Care Center | 13.6 mi | Blountville, TN | ★☆☆☆☆ | 1/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 445458.