Pickett Care and Rehabilitation Center
129 Hillcrest Drive, Byrdstown, TN 38549 · Pickett County · 69 certified beds · avg 56 residents/day · certified since Apr 1, 1997
Part of chain: SIGNATURE HEALTHCARE (67 facilities, chain avg rating 3.1★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
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.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Aug 14, 2019 · F-0656
The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Why it matters: Without a complete, working care plan, important needs can slip through the cracks and no one is accountable for results.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Nov 19, 2019 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Aug 14, 2019 · F-0689
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Nov 19, 2019 (Deficient, Provider has date of correction)
All citations in the current public record (17)
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 |
|---|---|---|
| Apr 9, 2025 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Apr 9, 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. |
| Apr 9, 2025 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Apr 9, 2025 | D · Potential for harm, one-off | The facility did not dispose of garbage and refuse properly. |
| Apr 9, 2025 | D · Potential for harm, one-off | The facility did not conduct and document a facility-wide assessment of what staff, supplies, and resources it needs to care for its residents properly — during everyday operations, nights, weekends, and emergencies. |
| Apr 9, 2025 | D · Potential for harm, one-off | 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 12, 2025 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Feb 12, 2025 | D · Potential for harm, one-off | The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint |
| Nov 17, 2021 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Nov 17, 2021 | 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. |
| Nov 17, 2021 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Nov 17, 2021 | D · Potential for harm, one-off | The facility did not make sure the resident's doctor reviewed their care and wrote, signed, and dated progress notes and orders at each required visit. |
| Nov 17, 2021 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Nov 17, 2021 | D · Potential for harm, one-off | 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. |
| Nov 17, 2021 | D · Potential for harm, one-off | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. |
| Aug 14, 2019 | ▲ G · Actual harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Aug 14, 2019 | ▲ G · Actual 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 stayed about the same across the last two inspection cycles (7 → 6).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2019 | 2 | 2 | G ▲ |
| 2021 | 7 | 0 | D |
| 2025 | 8 | 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) | 3.98 | 3.62 | 3.95 | top 21% in Tennessee; top 40% in the U.S. |
| Registered Nurse hours | 0.60 | 0.57 | 0.69 | top 34% in Tennessee; top 48% in the U.S. |
| Weekend total nurse staffing | 3.20 | 3.15 | 3.50 | top 36% in Tennessee; bottom 42% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.39 | 0.39 | 0.48 | top 39% in Tennessee; top 49% in the U.S. |
| Total nursing staff turnover (%) | 31.5 | 48.9 | 45.8 | top 9% in Tennessee; top 17% in the U.S. |
| RN turnover (%) | 14.3 | 43.2 | 42.9 | top 4% in Tennessee; top 7% 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 3.78, RN 0.57, weekend 3.04. Staffing rating: 4/5.
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: 4/5 · long-stay residents: 4/5 · short-stay residents: 3/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Agemo Holdings LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 10/01/2016 |
| Jjla LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 11/01/2007 |
| LP CR Holdings LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 11/01/2007 |
| LPSNF II LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 10/01/2016 |
| Steier III, Elmer | Individual | 5% or Greater Indirect Ownership Interest | — | 11/01/2007 |
| Wheaten LLC | Organization | 5% or Greater Indirect Ownership Interest | — | 11/01/2007 |
| Foster, Noah | Individual | W-2 Managing Employee | NOT APPLICABLE | 05/23/2023 |
| Harrison, John | Individual | Corporate Officer | NOT APPLICABLE | 11/01/2007 |
| Signature Healthcare LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 11/01/2007 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Can I see where garbage is stored and how often it's removed?"
- "How do you decide you have enough staff and resources for your resident population, including nights and weekends?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "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 |
|---|---|---|---|---|---|
| Clinton County Care and Rehabilitation Center | 8.4 mi | Albany, KY | ★★★★☆ | 4/5 | |
| Signature Healthcare of Fentress County | 14.4 mi | Jamestown, TN | ★★☆☆☆ | 2/5 | |
| Overton County Health and Rehab Center | 16.9 mi | Livingston, TN | ★★★★☆ | 4/5 | |
| Cumberland Valley Nursing & Rehabilitation Center | 19.8 mi | Burkesville, KY | ★☆☆☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 445390.