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Facility record report · CMS certification number 445543

TENNESSEE STATE VETERANS HOME- CLEVELAND

CLEVELAND, Tennessee · Medicare and Medicaid

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 July 2024 to 30 June 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 October 2025.

Revenue and expenses, fiscal year 2025
FigureAs filedWhere it comes from
Total patient revenue$11,526,054CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$571,684CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$10,954,370CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$12,287,626CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$1,333,256CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$114,873CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$1,218,383CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,218,383 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2025
FigureAs filedWhere it comes from
Total facility beds, all components108CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components39,420CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days900CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days4,330CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days20,734CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components25,964CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges16CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges22CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges64CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components102CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days56.25CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days196.82CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days254.55CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1441272, read from the public cost report file SNF10FY2024.zip.

Cost report for 16 February 2024 to 30 June 2024 — a reporting period of 135 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 3 December 2024.

None of these figures is carried on this report.

CMS report record 1399854, read from the public cost report file SNF10FY2024.zip.

Five facilities of a similar size in Tennessee, fiscal year 2025

Chosen for having certified bed counts closest to this facility’s, listed by name. Every one filed for the same fiscal year; the day each year ends differs and is shown. Each figure is that facility’s own filing.

FacilityTotal facility bedsTotal patient daysNet patient revenueTotal operating expensesNet income from service to patientsPeriod ended
DIVERSICARE OF OAK RIDGE12034,343$10,621,913$10,420,099$201,81428 February 2025
LCC OF EAST RIDGE10828,791$14,012,609$13,480,515$532,09431 July 2025
LIFE CARE CENTER OF HIXSON10832,540$14,930,281$13,744,307$1,185,97431 August 2025
ROCKY TOP CARE CENTER11732,283$9,073,996$8,620,715$453,28130 June 2025
TN STATE VETERANS HOME-CLARKSVILLE10838,207$17,016,486$17,924,713−$908,22730 June 2025
TSVH - CLEVELAND10825,964$10,954,370$12,287,626−$1,333,25630 June 2025

Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-10 worksheet S300001 line 800 column 100 · Total patient days: CMS-2540-10 worksheet S300001 line 800 column 700 · Net patient revenue: CMS-2540-10 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-10 worksheet G300000 line 400 column 100 · Net income from service to patients: CMS-2540-10 worksheet G300000 line 500 column 100.

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
BLEDSOE, COURTNEYADP OF THE SNFIndividualNOT APPLICABLEsince 03/20/2026
JACKSON, ROBERTADP OF THE SNFIndividualNOT APPLICABLEsince 06/21/2024
BLEDSOE, COURTNEYOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 07/11/2022
FLEMING, ADAMOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 04/20/2024
HARRIES, EDWARDOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/11/2010
JACKSON, ROBERTOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 06/21/2024

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of TENNESSEE STATE VETERANS HOME BOARD (enrollment ID O20240116000973).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
COURTNEY BLEDSOEIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.3/20/2026
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ROBERT ERIC JACKSONIndividualADP OF THE SNFCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.6/21/2024
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ADAM FLEMINGIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.4/20/2024
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
COURTNEY BLEDSOEIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.7/11/2022
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
EDWARD HARRIESIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/11/2010
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ROBERT ERIC JACKSONIndividualOPERATIONAL/MANAGERIAL CONTROLCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.6/21/2024
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
122 January 202622 January 202650
216 February 202416 February 202400

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

5 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
22 January 2026HealthF 0557Resident Rights DeficienciesHonor the resident's right to be treated with respect and dignity and to retain and use personal possessions.DNoDeficient, Provider has date of correction31 March 2026
22 January 2026HealthF 0582Resident Rights DeficienciesGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.DNoDeficient, Provider has date of correction31 March 2026
22 January 2026HealthF 0600Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.GYesDeficient, Provider has date of correction1 March 2026
22 January 2026HealthF 0641Resident Assessment and Care Planning DeficienciesEnsure each resident receives an accurate assessment.DNoDeficient, Provider has date of correction3 February 2026
22 January 2026HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.DNoDeficient, Provider has date of correction31 March 2026

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
22 January 2026Fine$13,520141025

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeGovernment - State
Legal Business NameTENNESSEE STATE VETERANS HOME BOARD
Date First Approved to Provide Medicare and Medicaid Services2024-02-16
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanY
County/ParishBradley
Telephone Number4238133600
Chain NameTENNESSEE STATE VETERANS' HOME
Chain ID704
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilResident
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds108
Average Number of Residents per Day101.7
Overall Rating2
Health Inspection Rating2
QM Rating3
Long-Stay QM Rating3
Short-Stay QM Rating2
Processing Date2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

Every change on this record

How to read this report

Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.

A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.

This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.

How to cite this report

Velarion Records, TENNESSEE STATE VETERANS HOME- CLEVELAND — facility record report, CMS certification number 445543. https://velarionrecords.com/facility/445543/report.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 445543. Velarion Records publishes these records as filed.

Nurse staffing, quarter by quarter

Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.

Nurse staffing hours by quarter
QuarterQuarter endedDays reportedResident daysRegistered nurse hoursLicensed practical nurse hoursNurse aide hoursTotal nurse hours
2024Q431 December 2024926,0465,08911,20015,921.532,210.5
2025Q131 March 2025906,4624,78512,10117,73234,618
2025Q230 June 2025918,3346,352.7512,27325,739.7544,365.5
2025Q330 September 2025929,4886,30713,713.2526,933.546,953.75
2025Q431 December 2025929,5696,014.514,022.525,542.7545,579.75
2026Q131 March 2026909,1525,195.513,910.2526,931.5346,037.28
Nurse staffing hours per resident day by quarter
QuarterRegistered nurse hours per resident dayLicensed practical nurse hours per resident dayNurse aide hours per resident dayTotal nurse hours per resident day
2024Q40.8417141.8524642.6333945.327572
2025Q10.7404831.872642.7440425.357165
2025Q20.7622691.4726423.0885235.323434
2025Q30.6647341.4453262.8386914.948751
2025Q40.628541.4654092.6693234.763272
2026Q10.567691.5199142.9426935.030297

How each quarter is derived, and its file

  • 2024Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv
  • 2025Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv
  • 2025Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv
  • 2025Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv
  • 2025Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv
  • 2026Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv

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