226 of the 303 Medicare-certified nursing homes in Tennessee (75%) are chain-owned, and all are listed below. 8 of the 225 graded homes earn an A and 19 earn a D or F. They average 3.67 nursing hours per resident per day, 0.13 hours below the 3.8 for every home in Tennessee. Nhc Healthcare, Kingsport in Kingsport grades highest at A (92 out of 100).
How chain-owned homes in Tennessee compare
This group set against every nursing home in Tennessee, from the current CMS release.
Nursing hours per resident per day
3.67
All homes in Tennessee: 3.8
Worse than the local average
Nurse staff turnover
49.1%
All homes in Tennessee: 48.9%
Worse than the local average
Average ElderGrade score
70.6/100
All homes in Tennessee: 71/100
Worse than the local average
Grade spread
B
C
D
8 grade A, 131 grade B, 67 grade C, 19 grade D,
The best-graded chain-owned home in Tennessee is
Nhc Healthcare, Kingsport
in Kingsport, TN, grade A, 92/100.
Midtown Center runs 180 beds in Memphis under for-profit LLC ownership, and the staffing numbers are where the trouble shows. At 3.54 nurse hours per resident day, it sits roughly 8% under the national average, and weekends dip about 13% below its own weekday levels, so care gets thinnest exactly when families are most likely to visit. Annual turnover of 63.6% is well above the 45.8% national figure, meaning nearly two-thirds of the nursing staff leaves each year. On inspections, the record carries 18 deficiencies, including 2 at harm or jeopardy level and 2 tied to abuse, plus a $188,379 fine.
Signature Health of Portland runs 112 certified beds under corporate ownership, and the staffing numbers are where the trouble starts: 3.69 nurse hours per resident day sits below the national average of 3.86, and weekends drop roughly 15% below the home's own weekday coverage. Turnover tells a harder story than the hours alone, 67.9% of staff leaving annually against a 45.8% national rate means aides and nurses are cycling through constantly, which matters most for residents who need consistent hands. The inspection record backs that up: 24 deficiencies, including 9 at harm or jeopardy level and 3 abuse-related, with five fines totaling $171,234 and a health inspection rating of 1 out of 5. That combination, thin weekend coverage, high turnover, serious deficiencies, is what a family should weigh before choosing here.
Lauderdale Community Living Center runs on 2.99 nurse hours per resident day, roughly a fifth below the national average, and weekends dip another 12 percent below its own weekday staffing. That thin coverage shows up in the numbers: a one-star inspection rating, 30 deficiencies on record including two at the harm level and one tied to abuse, plus $43,644 in fines. Staff turnover sits at 52.8 percent against a national 45.8, so more than half the workforce leaves each year. It's a for-profit limited liability company with 71 certified beds, and its last inspection was August 2025.
Signature Healthcare of Erin runs 164 certified beds under a for-profit LLC, with nurse staffing at 3.70 hours per resident day, about 4% under the national average, and weekends roughly 14% thinner than weekdays, when families often visit. Turnover sits at 47.7%, a couple points above the national figure, so the aides and nurses caringly assigned here may not be the same faces from one month to the next.
The inspection record carries more weight than any single number: nine deficiencies, four serious enough to involve harm or jeopardy, plus one abuse-related finding, and a $147,898 fine. The most recent inspection was March 2026.
Elk River Health & Nursing Center runs about 3.70 nursing hours per resident per day, a bit under the national average, and weekends drop roughly 13% below its own weekday staffing. That thin weekend coverage matters more when you consider turnover: nearly 70% of staff left last year, against a national average near 46%, and CMS gives the home its lowest mark on staffing. Inspections look better, a four-star health inspection rating, with nine deficiencies on record and none at the harm level, though one is abuse-related. The last inspection was July 30, 2025. Quality measures sit at two stars. Nonprofit ownership doesn't change the arithmetic: consistent hands are the hard part here.
Northbrooke Post Acute runs on 3.54 nurse staffing hours per resident day, roughly 8% under the national average, and weekends dip about 10% below what the home itself does on weekdays. That thin coverage is hard to separate from a 73.9% annual turnover rate, well above the 45.8% national figure, meaning the aides and nurses at the bedside are frequently new. The current record carries 32 deficiencies, none flagged at the harm or jeopardy level and none abuse-related, and the last full inspection was in April 2025. Inspections, quality measures, and staffing each land at or below the middle of CMS's five-star scale, with staffing at the bottom. A for-profit corporation owns the 120 certified beds.
The numbers at Mt Pleasant Healthcare and Rehabilitation point to a staffing problem more than anything else. Nurses provide about 3.29 hours of care per resident each day, roughly 15 percent below the national average, and weekends get thinner still, about 15 percent below the home's own weekday coverage. That gap matters because turnover runs at 61 percent, well above the 45.8 percent national figure, meaning the staff who are there keep changing.
The inspection record is mixed: a March 2025 visit, a 3-star health inspection rating, but 10 deficiencies on file, including one at the harm level and two tied to abuse. A for-profit limited liability company owns the 72-bed home, and CMS has fined it once for $7,443.
Laurelwood runs 64 beds in Jackson under corporate ownership, and its staffing sits just under the national average at 3.82 nurse hours per resident day. That number hides a sharper problem: weekend coverage drops about 17% below what the home staffs on weekdays, and 60% of its staff turn over each year against a national rate near 46%. Twenty deficiencies sit on the current record, including two at the harm or jeopardy level and two tied to abuse, with $168,961 in fines across two penalties. The last inspection was January 22, 2026. A family weighing this one should ask directly how weekends are covered and what changed since those abuse findings.
Lyonsview runs 222 certified beds in Knox County, and the numbers there deserve a hard look before you sign anything. Nurse staffing sits at 3.55 hours per resident per day, roughly 8% under the national figure, and weekends drop about 9% below what the home manages on weekdays, so the thinnest coverage lands exactly when families tend to visit. Staff turnover is 59.4% against a 45.8% national average, which means more than half the caregivers you'd meet are likely gone within a year. The current record shows 18 deficiencies, 8 serious enough to involve harm or jeopardy, 4 tied to abuse, and CMS has placed the home in its Special Focus Facility program.
Spring Gate runs 206 beds in Memphis under for-profit LLC ownership, and its last inspection was in October 2024. The raw staffing number looks fine, 3.95 nurse hours per resident day, just above the national average, but that figure hides two problems: weekend coverage drops about 13% below the home's own weekday level, and annual turnover sits at 67.5% against a national 45.8%, meaning most of the people providing that care are new or on their way out. The inspection record is where it gets serious: 37 deficiencies, three at harm or jeopardy level, two tied to abuse, and $128,974 in fines. Quality measures score well, but a 1-star inspection rating and 2-star staffing tell you where to look first.
Church Hill Post-Acute and Rehabilitation Center carries 35 deficiencies on its current record, and 12 of those rose to the level of actual harm or jeopardy, a count that should stop you before anything else. Six are abuse-related, and CMS has placed the home in its Special Focus Facility program, which is reserved for the homes with the most persistent problems. Nurse staffing sits at 3.51 hours per resident day, roughly 9% under the national average, and weekends run about 12% below the home's own weekday level. Staff turnover is 52.4%, well above the 45.8% national figure. One fine on record totals $250,780. The last inspection was February 12, 2026.
Nursing aides and nurses here give each resident about 2.96 hours of care a day, and the national average is 3.86, so this home runs roughly a quarter leaner than most. That shortfall shows up worse on weekends, when staffing drops about 15% below its own weekday level, and nearly six in ten staff left over the past year against a national rate closer to 46%. The inspection record is the harder read: 35 deficiencies, seven serious enough to put residents in harm's way, three tied to abuse, and one $205,329 fine. CMS flags it as a Special Focus Facility, meaning it's on a watch list for homes with a pattern of poor care. Its last inspection was September 2023.
Eaton Creek Post Acute has more direct-care nursing hours than most homes, 5.04 per resident day against a national average of 3.86, and it holds that level through the weekend, which many places don't. The problems sit elsewhere. Thirty-five deficiencies are on the current record, twelve of them serious enough to put residents in harm's way and five tied to abuse, with $122,242 in federal fines across three cases. Staff turnover runs 52.9% a year, above the 45.8% norm, and CMS has placed the home in its Special Focus Facility program, a designation reserved for the most persistent poor performers. The last inspection was August 30, 2023.
Rainbow Rehab And Healthcare runs 115 certified beds in Bartlett under for-profit limited liability ownership. Nurse staffing sits at 3.41 hours per resident day, roughly 12 percent under the national average, and weekends drop about 17 percent below the home's own weekday coverage, so the thinnest shifts land when families tend to visit. Turnover is 43.7 percent, slightly better than the national 45.8 percent, and the current record shows seven deficiencies with none at harm or jeopardy level and no abuse findings. What stands out is timing: the last inspection was June 30, 2022, meaning the two-year-old findings behind that 2/5 inspection rating may not reflect how the building runs today.
Beech Tree runs 3.29 nursing hours per resident per day, roughly 15% under the national average, with weekends even thinner than weekdays. The inspection record is the harder problem: 23 deficiencies, eight of them at harm or jeopardy level and five tied to abuse, plus a $138,802 fine. That combination landed it in CMS's Special Focus Facility program, a designation reserved for the homes regulators watch most closely. Staff turnover, at 44.7%, is actually a hair better than average, so the trouble looks less like a retention crisis than a home that hasn't fixed the practices inspectors keep flagging since its April 2024 visit.
Holston Rehabilitation and Care Center runs 204 beds in Kingsport, and the staffing numbers are where I'd start. At 3.63 nurse hours per resident day, it sits about 6% under the national average, and weekends drop roughly 11% below its own weekday level, so coverage thins out exactly when families tend to visit. Annual turnover is 68.1%, well above the 45.8% national figure, which usually means less continuity for residents. The current record shows 23 deficiencies, including one at the harm level and two abuse-related, plus a $16,720 fine. Inspections were recent, in November 2025, and the health, quality, and staffing ratings all land at two stars or lower.
Smyrna Care Center runs on thin staffing even by industry standards, 3.22 nurse hours per resident day against a national average of 3.86, with weekends dipping further below its own weekday numbers. That gap matters more when you look at turnover: 65% of staff leave each year, well above the 45.8% national figure. The inspection record is the harder read. Thirty deficiencies, six of them serious enough to put residents in harm's way, and one tied to abuse. The last full inspection was February 2020, more than five years ago. Corporate ownership, 125 beds. Families deserve to know all of this before deciding.
The Mckendree Post Acute & Rehabilitation is a 180-bed nonprofit home in Hermitage that CMS has placed in its Special Focus Facility program, a designation reserved for homes with a persistent record of poor inspections. The numbers explain why: 37 deficiencies on the current record, including four at the harm or jeopardy level and five tied to abuse, plus a single fine of $252,242. Staffing sits at 3.50 nurse hours per resident day, about 9% under the national average, and weekends run roughly 12% thinner than weekdays. Annual turnover is 58% against a national 45.8%. Its last inspection was October 2023. If you're considering this home, ask what's changed since then.
Orchardview runs on thin staffing. At 3.39 nurse hours per resident per day, it sits about 12% under the national average of 3.86, and the weekend numbers don't drop further, so there's no extra coverage cushion when census or acuity spikes. The bigger red flag is turnover: 70.8% annually, against a national average of 45.8%. That's a building where most of the people caring for your relative will be gone within a year.
The inspection record backs that up. Nineteen deficiencies on file, four of them serious enough to involve harm or jeopardy, five tied to abuse. Three fines totaling $94,905. The most recent inspection was January 2025, so the record is current, not stale. All three CMS star ratings, health inspections, quality measures, and staffing, land at 2 out of 5.
Shelby Oaks Post Acute runs on 3.51 nurse staffing hours per resident day, about 9% under the national average, and weekends drop roughly 17% below what the home staffs during the week. That thin coverage shows up in the numbers: 59.7% annual turnover, against a national average of 45.8%, meaning most of the people caring for residents weren't there a year ago. The inspection record is worse, 22 deficiencies, two at harm or jeopardy level, two tied to abuse, and $83,589 in fines. The last inspection was January 8, 2026, so the record is recent, not stale. This is a for-profit LLC with a one-star health inspection rating and a one-star staffing rating.
Frequently asked questions
How many chain-owned nursing homes are there in Tennessee?
There are 226 chain-owned Medicare-certified nursing homes in Tennessee, 75% of the 303 nursing homes there.
Are chain-owned nursing homes better staffed?
In Tennessee they average 3.67 total nursing hours per resident per day, against 3.8 for all nursing homes in Tennessee, a difference of -0.13 hours. Staff turnover averages 49.1% against 48.9%.
Which chain-owned nursing home grades best in Tennessee?