Her mother, Lettie Fox, 93, has called Hillcrest West her home for more than ten years.

But Jane Wilkes has no choice but to move her to Hillcrest North, a 20-minute drive across Knoxville.

"It's heartbreaking," Wilkes says.

"But there seems to be nothing we can do. Nothing!"

Lanny Green knows Hillcrest West can't and won't throw his mother Irene, 87, into the street.

But that's where he and his friends stood Thursday morning, clad in bathrobes, raising canes and walkers, flashing signs asking "where
will we go.?"

He's gonna have to take his mother to Anderson County, Sevier county, even all the way down to Kingston," friend Richard Wade says.

"I would hope that Medicare, Medicaid would evaluate their situation here," Green says.

If not, the Centers for Medicare & Medicare Services will cut all reimbursements to Hillcrest West March 8. Decertification will take effect Fenruary 6.

The measures come after the nursing home spent 18 months on the federal government's "critical list" for what inspectors considered a pattern of violations and shortfalls in patient care quality and staffing. Most recently, Hillcrest West earned one star on the Centers' five-star grading scale.

Grace Healthcare has operated Hillcrest West since March 2009.

"I can't see why Medicare-Medicaid is on it so hot,"Wilkes says.

"There's other facilities in Tennessee they could run ragged if they wanted to!"

"I think moving these patients out of here is creating much more of a hardship," Green says.

"You're gonna kill half of 'em! Because they're too old to be moved!"

Grace has considered converting more of West's beds to "assisted- living," according to manager Joshua Lowe.

Other options include converting the nursing wing to 'full ride, paying patients only.' Seventeen such patients will remain at Hillcrest West, Lowe says, paying, on average $5,000 a month.

Both options would require re-certification through the U.S. Department of Health and Human Services. Neither would be likely to be achieved quickly, Lowe says.

Green admits the feds probably count his mother's fall on Christmas Day against Hillcrest West.

But he doesn't want her restrained.

"I think most of the employees have a feel for patient needs," he says.

"There's a real family atmosphere here."

"My mother's on hospice," Wilkes says.

And I hope and pray to God, He takes her before she ever goes out of here."