CCN 445171

The Waters of Shelbyville, LLC

835 UNION STREET, Shelbyville, TN 37160 · Bedford County

Phone: (931) 680-2300
Ownership: For profit - Limited Liability company
Certified beds: 96
Residents per day: 75.3
Health citations: 9
Penalties: 0
Fines: 0 · $0
Map: Open location

Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections

Overall

CMS overall star rating in this file.

Health inspection

Compared with other homes in the state.

Staffing

Based on reported PBJ nurse hours.

Quality measures

Long-stay 5 · short-stay 4.

Provider Information star ratings. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections

Staffing hours

Reported hours per resident per day come from the Payroll-Based Journal figures in the Provider Information file. Case-mix and adjusted hours account for how much care CMS expects given the residents’ needs. State and U.S. figures are averages from the same release.

Measure: This home; State; U.S.
Nurse aide: 1.57; 2.12; 2.32
LPN/LVN: 1.25; 1.09; 0.86
Registered nurse: 0.32; 0.60; 0.69
Total nurse staff: 3.14; 3.80; 3.86
Weekend total: 2.67; 3.31; 3.42
Weekend RN: 0.20; 0.39; 0.48

Adjusted total nurse hours: 2.41. Adjusted RN hours: 0.25. Case-mix total: 4.98. Case-mix index: 1.821.

Total nursing staff turnover: 52.5%. RN turnover: 80.0%. Administrators who left: 0.

How to read staffing hours

Payroll-Based Journal figures in Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections

Fines and penalties

CMS reports 0 fines totaling $0, and 0 payment denials.

The Penalties file has no individual penalty rows for this CCN.

Cycle 1 standard survey: February 27, 2026. Health deficiencies counted in cycle 1: 0. Cycle 1 total health score: 0.

Cycle 2 standard survey: November 6, 2019. Cycle 2/3 health deficiencies: 6. Total weighted health survey score: 11.

Penalties file and Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections

Health inspection citations

The Health Deficiencies file lists 9 citations for this home, including 1 at immediate jeopardy and 0 at actual harm. CMS may display some citations here that are not used in the health inspection rating, including citations under dispute.

November 29, 2023

2 citations

Tag	What CMS cited	Scope and severity	Status
F684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Complaint survey · Cycle 3	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · January 11, 2024
F695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Complaint survey · Cycle 3	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · January 11, 2024

November 6, 2019

4 citations

Tag	What CMS cited	Scope and severity	Status
F689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Standard survey · Cycle 2	J: isolated, immediate jeopardy to resident health or safety	Past Non-Compliance · August 20, 2019
F812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Standard survey · Cycle 2	E: pattern, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · December 9, 2019
F550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Standard survey · Cycle 2	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · December 9, 2019
F658	Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Standard survey · Cycle 2	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · December 9, 2019

December 5, 2018

3 citations

Tag	What CMS cited	Scope and severity	Status
F657	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Standard survey · Cycle 3	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · January 15, 2019
F693	Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. Quality of Life and Care Deficiencies · Standard survey · Cycle 3	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · January 15, 2019
F758	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Pharmacy Service Deficiencies · Standard survey · Cycle 3	D: isolated, no actual harm, with potential for more than minimal harm	Deficient, Provider has date of correction · January 15, 2019

Health Deficiencies. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections

Other facts in the provider file

Provider type: Medicare and Medicaid.
Chain name in the file: Infinity Healthcare Consulting (70 facilities). Chain average overall rating: 2.1.
First approved for Medicare and Medicaid services: January 11, 1985.
Resident and family council: Resident.
Automatic sprinklers in all required areas: Yes.
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Questions

What is the CMS overall rating for The Waters of Shelbyville, LLC?

The Waters of Shelbyville, LLC has an overall rating of 4 out of 5. The health inspection rating is 4, staffing is 1, and the quality measure rating is 5.

How many health citations does CMS list for The Waters of Shelbyville, LLC?

The Health Deficiencies file lists 9 health citations for this home. 1 are coded immediate jeopardy (J, K, or L) and 0 are coded actual harm that is not immediate jeopardy (G, H, or I).

What nurse staffing does CMS report for The Waters of Shelbyville, LLC?

CMS reports 3.14 total nurse hours per resident per day, including 0.32 registered nurse hours. These are Payroll-Based Journal measures in the Provider Information file.

CMS file

Staffing hours

Fines and penalties

Health inspection citations

November 29, 2023

November 6, 2019

December 5, 2018

Other facts in the provider file

Questions

Opening the record…

Staffing hours

Fines and penalties

Health inspection citations

November 29, 2023

November 6, 2019

December 5, 2018

Other facts in the provider file

Questions