Towne Square Care Of Puryear

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

Therapy staffing: this home’s payroll records show 0.29 therapist hours per resident per day in 2026Q1 — more than 46% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 4% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 32 beds and averages 25.4 residents a day — about 79% occupied, or roughly 7 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.29 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.52 is below the 0.55-hour RN benchmark and nurse-aide staffing of 3.03 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 2.83 hrs/resident/day on weekends vs 4.88 on weekdays — 42% thinner on weekends — a notable drop. RN hours go from 0.65 to 0.21 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 23% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

16 citations, most serious first. The 10 most serious are shown; the remaining 6 are one tap away and print in full.

• Potential for harm · Ecited before2026-05-19 · tag F0812 — failed to store, cook, and serve food safely — pattern
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on facility policy review, observation, and interview, the facility failed to ensure food was stored, prepared, and served under sanitary conditions when undated, unlabeled food items were found stored in the kitchen. The facility had a census of 24 and 24 of the residents were served from the Kitchen. The findings include: 1. Review of the undated facility policy titled, Food Storage (Dry, Refrigerated, and Frozen) revealed .Food shall be stored on shelves in a clean, dry area free from contaminants Food shall be stored at appropriate temperatures and using appropriate methods to ensure the highest level of food safety.All food-items will be labeled. The label must include the name of the food and the date by which it should be sold, consumed, or discarded.Discard food that has passed the expiration date, and discard food that has been prepared in the facility after seven days of storing under proper refrigeration.Leftover contents of cans and prepared food will be stored in covered, labeled and dated containers in refrigerators and/or freezers . 2. Observation in the kitchen…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-05-19 · tag F0761 — failed to label and store drugs safely — isolated
  Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on facility policy review, medical record, observation, and interview, the facility failed to ensure medications were properly stored when 2 of 2 medication storage carts (Hall 1 and Hall 2) had expired and outdated medications. The findings include: 1. Review of the facility's policy titled, Medication Storage, dated 2/1/2017, revealed .No discontinued, outdated, or deteriorated medications should be available for use in the facility.Expired medications are to be removed from areas medication carts prior to or at the time of expiration. 2. Review of the medical record revealed Resident #3 was admitted to the facility on [DATE], with diagnoses including Hypertension, Kidney Disease, and Dementia. Review of the quarterly Minimum Data Set (MDS) dated [DATE], revealed Resident #3 scored a 15 on the Brief Interview for Mental Status (BIMS) assessment, which indicated he was cognitively intact. Review of the Physician Order dated 12/8/2025, revealed .clonidine HCI [medication used to treat high blood pressure]…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-05-19 · tag F0851 — isolated
  Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on policy review, Centers for Medicare & [and] Medicaid Services Electronic Staffing Data Submission Payroll-Based Journal Long-Term Care Facility Policy Manual review, Quarterly Payroll Based Journal (PBJ) review, facility staffing information review, and interview, the facility failed to submit accurate staffing data for Quarter 1 for PBJ 2026 (October 1, 2025- December 31, 2025) reviewed for staffing data. The findings include: 1. Review of the facility policy titled Policy & Procedure: PBJ Reporting, dated 10/1/2024, revealed To ensure all necessary staffing hours are submitted to the Centers for Medicare & Medicaid Services as required. Review of the Centers for Medicare & Medicaid Services Electronic Staffing Data Submission Payroll-Based Journal Long-Term Care Facility Policy Manual dated June 2025, revealed .Direct care staffing and census data will be collected quarterly, and is required to be timely and accurate. Review of the facility PBJ Staffing Data Report for Quarter 1 2026 (October 1, 2025- December 31, 2025) revealed there were no daily Registered Nurse (RN)…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2025-03-26 · tag F0812 — failed to store, cook, and serve food safely — pattern
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on policy review, observation, and interview, the facility failed to maintain a sanitary kitchen when 1 of 1 ice machines was observed to have a dark slimy build up and when 1 of 1 nourishment refrigerator had a yellow sticky substance in the freezer and refrigerator. The findings include: 1. The facility policy titled, Policy & Procedure: Sanitizing, dated 2/1/2017, revealed .food storage .areas will be kept clean and free from litter, debris .All equipment .shall be washed to clean and sanitize using hot water and/or chemical sanitization solution .Ice machines .will be .cleansed and sanitized . 2. Observation in the kitchen on 3/24/2025 at 8:40 AM, revealed a dark slimy build up on inside of the ice machine. During an observation and interview on 3/24/2025 at 8:45 AM the Certified Dietary Manager (CDM) was asked if there should be a build up of dark slime in the ice machine. She stated, No . During an interview on 3/25/2025 at 2:15 PM, the Administrator confirmed there should not be black slime in the ice machine. 3. During an observation and interview in the medication…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-03-26 · tag F0656 — failed to write and follow a full care plan — isolated
  Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to develop am elopement risk care plan for 1 of 12 (Resident #4) sampled residents reviewed for care plans. The findings include: 1. Review of the facility policy titled, .Care Planning, dated 2/1/2017, revealed .To ensure all residents have a care plan developed, implemented, revised/updated based on the needs they have .Care plans will be initiate .and updated and/or revised .with any changes that occur throughout their stay . 2. Review of the medical record review revealed Resident #4 was admitted to the facility on [DATE], with diagnoses including Impulse Disorder, Paranoid Schizophrenia, Dementia, and Anxiety. Review of the quarterly Minimum Data Set (MDS) dated [DATE], revealed Resident #4 had a Brief Interview for Mental Status (BIMS) score of 11, meaning Resident #4 had moderate cognitive impairment. Review of the Care Plan dated 12/29/2024, revealed there were no focus/problems or interventions on the care plan related to…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-03-26 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, named Hospice agreement review, medical record review, and interview, the facility failed to provide a communication process, including how the communication will be documented between the Long-term Care facility and the hospice provider to ensure resident needs are addressed and met for 1 of 12 (Resident #7) sampled residents and failed to follow Physician Orders for 1 of 12 (Resident #16) sampled residents. The findings: 1. Review of the facility policy titled, Policy & Procedure: Hospice Services, dated 2/1/2017, revealed .It is the policy of the facility to provide collaborative care with Hospice providers to ensure that our resident's end of life preferences and choices are honored .Communication will be documented between the facility and the hospice provider, to ensure that the needs of the resident are addressed and met . 2. Review of the named Nursing Facility Hospice Agreement, dated July 2017, revealed .Manner of Communication .All communications between the Hospice and Nursing…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-03-26 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, observation, and interview, the facility failed to ensure a safe and secure environment when hazards items were found in 2 of 18 (Resident #18 and #22) resident rooms reviewed for accidents. The findings included: 1. Review of the facility's policy titled, Resident Rooms, dated 2/1/2017, revealed .To ensure residents are provided a clean room and environment and free of hazards . 2. Review of the medical record revealed Resident #18 was admitted to the facility on [DATE], with diagnoses including Diabetes, Asthma, and Dementia. Review of the quarterly Minimum Data Set (MDS) dated [DATE], revealed Resident #18 had a Brief Interview for Mental Status Score (BIMS) of 15, indicating the resident was cognitively intact, and required supervision with Activities of Daily skills (ADLs). Observations during medication administration in the resident's room on 3/24/2025 at 4:11 PM and on 3/25/2025 at 10:51 AM, revealed the following: a. a bottle of pink nail polish, an 18 oz…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-03-26 · tag F0732 — isolated
  Post nurse staffing information every day.
  What the surveyor found here — the official record, unedited, may be distressing

  Based on policy review, daily staff posting review, and interview, the facility failed to post the total number of staff, and actual hours worked by the licensed staff responsible for resident care on the facility's Daily Staff Posting form for 20 of 24 sampled days. The findings include: 1. Review of the facility policy titled, .Staffing, dated 2/1/2017, revealed .To ensure proper licensed nursing staff are provided to the residents according to regulations .Resident census will be posted daily. 2. Review of the facility's Daily Staff Posting forms dated 3/1/2025 thru 3/24/2025, revealed incomplete daily posting for the dates of 3/1/2025, 3/2/2025, 3/3/2025, 3/4/2025, 3/5/2025, 3/6/2025, 3/7/2025, 3/10/2025, 3/11/2025, 3/12/2025, 3/13/2025, 3/14/2025, 3/15/2025, 3/16/2025, 3/17/2025, 3/18/2025, 3/19/2025, 3/20/2025, 3/21/2025, and 3/24/2025. During an interview on 3/25/2025 at 4:14 PM, the Director of Nursing (DON) was asked about the missing documentation related to the daily staff posting form. The DON confirmed there was missing documentation, and the form was not accurate.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-03-26 · tag F0759 — failed to keep medication error rate low — isolated
  Ensure medication error rates are not 5 percent or greater.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, observation, and interview, the facility failed to ensure 1 of 2 (Registered Nurse (RN) A) nurses administered medications with a medication error rate of less than 5 percent (%). A total of 2 errors were observed out of 26 opportunities, resulting in a medication error rate of 7.69%. The findings include: 1. Review of the facility's policy titled, Medication Error, revealed .All medication errors and drug reactions will be reported immediately to the Director of Nursing, the attending physician and will be documented according to established procedures .Medication error is defined as the preparation or administration of medications or biological that is not in accordance with the prescriber's orders, manufactures specifications regarding the preparation and/or administration of the medication or biological and /or accepted professional standards for medications or biological administration .All medication errors and drug reactions must be promptly reported to the…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-03-26 · tag F0761 — failed to label and store drugs safely — isolated
  Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, observation, and interview, the facility failed to ensure medications were properly stored and secured when 1 of 3 (Short Hall Medication Cart) medication storage areas was found unsecured and unattended when medications were found unsecured and unattended in 1 of 18 (Resident #22) resident occupied rooms. The findings include: 1. Review of the facility's policy titled, Medication Storage, dated 2/1/2017, revealed .To ensure that medications and biological (biologicals) are stored in a safe, secure storage and safe handling .Compartments containing medications should be locked when not in use .Trays and carts used to transport such items should not be left unattended . 2. Review of the medical record revealed Resident #22 was admitted to the facility on [DATE], with diagnoses including Anxiety, Chronic Pain Syndrome, Hypertension, and Asthma. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #22 had a Brief Interview for…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

No federal fines in the current CMS record.

Who owns this facility

CMS files one row per role, so the 4 rows in the source record cover these 2 parties — each is shown once here with every role it holds. Nothing is omitted.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in TN