CCN 445458 · Washington County, Tennessee
Four Oaks Health Care Center
1101 Persimmon Ridge Rd, Jonesborough, TN 37659
Four Oaks Health Care Center is a 84-bed for-profit nursing home in Jonesborough, Tennessee, first certified for Medicare or Medicaid in 2002. CMS rates it 4 out of 5 stars overall in its September 2026 data, and it averaged 59.8 residents a day, about 71% of its certified beds. It has an active FHA-insured Section 232 loan: $6.5 million originally, at 3.59%, with $5.5 million outstanding as of September 30, 2026 and maturity in August 2049.
Facility facts
- Certified beds
- 84
- Average residents per day
- 59.8 (71.2% of beds)
- Ownership type
- For profit - Corporation
- Certification
- Medicare and Medicaid
- Legal business name
- Four Oaks Operating Group LLC
- Certified since
- Jul 1, 2002
- Chain or affiliated group
- Ahava Healthcare (16 facilities, chain average 2.4 stars)
- Location
- Urban
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | Tennessee median | US median |
|---|---|---|---|
| Overall rating | 4 of 5 | State spread: 58 at 1, 53 at 2, 65 at 3, 68 at 4, 56 at 5 | |
| Health inspections | 4 of 5 | ||
| Quality measures | 5 of 5 | ||
| Staffing | 1 of 5 | ||
| Total nurse hours per resident per day | 3.47 | 3.64 | 3.68 |
| RN hours per resident per day | 0.30 | 0.54 | 0.58 |
| Weekend nurse hours per resident per day | 2.96 | ||
| Nursing staff turnover | 68.1% | 50.0% | 44.9% |
| Occupancy (residents / beds) | 71.2% | 77.7% | 85.7% |
| Fines reported by CMS | None | ||
| Health deficiencies, latest standard survey | 2 (Dec 3, 2025) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Four Oaks Health Care Center meets that part today: 4 stars overall, 4 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| McE Associates LLCOrganization | Direct Ownership Interest | 10% | 04/28/2017 |
| Labin, ShiyaIndividual | Direct Ownership Interest | 8% | 04/28/2017 |
| Neuman, BenjaminIndividual | Direct Ownership Interest | 10% | 04/28/2017 |
| Niederman, AnshelIndividual | Direct Ownership Interest | 30% | 04/28/2017 |
| Edwards, TammyIndividual | Operational / Managerial Control | n/a | 06/13/2022 |
| Rosenhein, BrianIndividual | Operational / Managerial Control | n/a | 06/13/2022 |
Changes of ownership
| Effective | Buyer | Seller |
|---|---|---|
| Apr 28, 2017 | Four Oaks Operating Group LLC | Integrity Healthcare of Jonesborough, LLC |
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| Jul 18, 2019 | 223(f) refinance or purchaseHUD project name: MFI - Four Oaks Health Care Center, 82 beds. Lender at endorsement: Greystone Funding Company LLC | $6,496,000 | Active: 3.59%, $5,523,662 balanceMatures Aug 1, 2049. Servicer: Greystone Servicing Company | 08722046 |
| Sep 8, 2011 | 223(f) refinance or purchaseHUD project name: Four Oaks Health Care Center, 82 beds. Lender at endorsement: Lument Real Estate Capital, LLC | $3,783,700 | Ended Apr 28, 2017Prepayment | 08722021 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.