Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Brickyard Healthcare - Knox Care Center during CMS and state inspections, most recent first.
A resident with dementia and diabetes was observed over several days with a persistent scabbed area on the left upper cheek/temple. Although the care plan called for monitoring and weekly documentation, there was no documentation of the resident's skin-picking behavior or reasons for the wound's lack of healing. The DON confirmed awareness of frequent skin-picking but could not provide evidence that this was documented or care planned, resulting in a deficiency.
A resident with a history of depression, insomnia, and seizures experienced ongoing sleep difficulties after discontinuation of trazodone. Although the care plan required monitoring of sleep patterns, there was no documentation that this was done, and the DON was unaware of the resident's complaints. The deficiency was related to the lack of monitoring and documentation of the resident's sleep patterns as outlined in the care plan.
A resident with a history of UTIs and chronic kidney disease was observed multiple times with indwelling Foley catheter tubing touching the floor while seated in a wheelchair. Although nursing staff were present, the tubing was not secured as required, despite the resident's care plan specifying catheter care and monitoring for infection.
A resident with chronic kidney disease, heart failure, and severe cognitive impairment experienced significant weight loss. Although the RDN recommended a protein supplement and ice cream at lunch to address nutritional needs, these recommendations were not implemented due to a lack of follow-up and communication, resulting in no updated dietary or physician orders.
A resident with an indwelling urinary catheter underwent a urinalysis and was started on antibiotics for a suspected UTI, but there was no documentation in the clinical record prior to the urinalysis indicating the reason for the test. The DON later explained the resident had behavioral and urine changes, but no supporting documentation was available before the urinalysis results were recorded.
An LPN did not change gloves or perform hand hygiene after cleaning a resident's pressure ulcer and before applying wound treatment, contrary to facility policy. The DON confirmed the LPN thought she had changed gloves after wound cleansing.
The facility failed to develop comprehensive care plans for pain management for two residents receiving opioid medications. One resident with hypertension and Parkinson's disease was on tramadol, while another with dementia and renal cancer was on Norco. Both lacked care plans addressing their pain management needs, despite facility policy requiring such plans within seven days of the MDS assessment. The DON acknowledged the oversight following a mock survey.
The facility failed to update and implement care plans for three residents. A resident with a wound vac did not have the device included in her care plan. Another resident's care plan was not updated to reflect a change in antipsychotic medication, and a third resident's care plan still included a discontinued sleep medication. The DON and VPRC acknowledged these oversights during a mock survey.
A cognitively impaired resident with Alzheimer's and other disorders was often found in a dark room without music or TV, despite needing one-to-one activities like listening to Christian music and receiving tactile stimulation. The facility's documentation showed inconsistent activity implementation, and interviews revealed that the resident's wakefulness cycles were not documented in the care plan.
Failure to Update and Implement Care Plan for Persistent Wound
Penalty
Summary
The facility failed to ensure that care plans were properly implemented and updated for a resident with a persistent scabbed area on the left upper cheek/temple. Over several days, the resident was observed with the same scabbed area, and the resident was unable to recall how the injury occurred or how long it had been present. The resident's diagnoses included dementia, type 2 diabetes mellitus, and hypertension, and the MDS assessment indicated cognitive impairment and a need for staff assistance with ADLs. The care plan in place noted the scab and included interventions to monitor and document the area weekly, but there was no documentation regarding any skin-picking behaviors or reasons for the lack of healing. A skin check note indicated the wound was acquired in-house, had been present for over three months, and had stopped improving. Despite the DON's knowledge that the resident frequently picked at the area, there was no documentation or care plan update to address this behavior. The lack of documentation and failure to update the care plan to reflect the resident's skin-picking behavior and the persistent nature of the wound led to the deficiency.
Failure to Monitor Sleep Patterns per Care Plan
Penalty
Summary
A resident with diagnoses including major depressive disorder, insomnia, and seizures reported ongoing difficulty sleeping after her trazodone was discontinued. The resident was cognitively intact and had a care plan in place that identified her as being at risk for sleep pattern disturbances related to insomnia. The care plan included interventions such as administering sleep medications as ordered, assessing for side effects, and monitoring the resident's usual sleep patterns. Despite these interventions being outlined in the care plan, there was no documentation in the resident's record indicating that her sleep patterns were being monitored. The resident continued to report sleep issues, and a psychiatry progress note confirmed ongoing concerns with sleep and depression, with staff reportedly monitoring sleep patterns. However, the Director of Nursing was unaware of the resident's complaints, and the record lacked evidence of any sleep pattern monitoring as required by the care plan.
Catheter Tubing Not Maintained Off Floor for Resident with UTI History
Penalty
Summary
A deficiency was identified when a resident with a history of urinary tract infections, chronic kidney disease, and urinary retention was observed multiple times sitting in a wheelchair with the indwelling Foley catheter tubing touching the floor. The catheter collection bag was placed in a dignity bag under the chair, but the tubing was not properly secured, resulting in it coming into contact with the floor. During these observations, nursing staff were present in the area, including at the nurses' station and during a medication pass, but the issue with the catheter tubing was not addressed at the time. The resident's medical record confirmed the presence of an indwelling catheter and ongoing treatment for a urinary tract infection. The care plan included interventions such as providing catheter care per orders and monitoring for signs and symptoms of UTI. Despite these documented interventions, the catheter tubing was not maintained off the floor as required, which constituted a failure to provide appropriate catheter care for the resident.
Failure to Implement Timely Dietary Recommendations for Resident with Weight Loss
Penalty
Summary
A resident with chronic kidney disease, heart failure, and a history of significant weight loss was admitted, discharged, and subsequently readmitted to the facility. The resident was identified as severely cognitively impaired and had experienced weight loss not associated with a prescribed regimen. The care plan noted nutritional concerns, including recent weight loss and dietary restrictions, and included interventions such as monitoring intake and having the Registered Dietician (RDN) evaluate and recommend dietary changes as needed. A nutrition assessment recommended daily ProT gold (a protein supplement) and ice cream at lunch to support weight maintenance due to skin impairments. However, there were no updated dietary or physician orders reflecting these recommendations. The DON stated that RDN recommendations were communicated via email, but did not recall receiving any updates for this resident, resulting in the recommendations not being implemented. Facility policy required RDN recommendations to be followed up with the physician for orders, but this process was not completed in this case.
Incomplete Documentation Prior to Urinalysis for UTI Evaluation
Penalty
Summary
The facility failed to maintain complete and accurate clinical records for a resident with an indwelling urinary catheter who was evaluated for a urinary tract infection (UTI). The resident, who had diagnoses including hypertension, diabetes mellitus, and dementia, was noted to be moderately cognitively impaired and had a care plan in place to monitor for signs and symptoms of UTI. The care plan specified that staff should monitor, record, and report any symptoms such as pain, burning, changes in urine, fever, chills, altered mental status, or behavioral changes. On review, there was documentation of a urinalysis being reviewed by the physician and a new antibiotic order being received. However, there was no documentation in the progress notes or assessments prior to the urinalysis to indicate the reason for obtaining the test. During interview, the DON stated the urinalysis was performed due to observed changes in the resident's behavior and urine appearance, but was unable to provide any documentation supporting these observations prior to the urinalysis being completed.
Failure to Follow Infection Control Protocol During Wound Care
Penalty
Summary
During a wound care procedure for a resident with a pressure ulcer on the left heel, an LPN was observed failing to change gloves and perform hand hygiene after cleaning the wound and before applying the prescribed treatment. The LPN initially donned a gown and gloves, removed the resident's heel protector boot and sock, then removed her gloves and washed her hands. She then put on new gloves, cleaned the wound, and applied the treatment without changing gloves or performing hand hygiene between these steps. This practice was not in accordance with the facility's current policy, which requires hand hygiene and donning of clean gloves after wound cleansing and before applying topical treatments. The DON later confirmed that the LPN believed she had changed her gloves after cleaning the wound.
Deficiency in Pain Management Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive care plans for pain management for two residents, leading to a deficiency. Resident 21, who had diagnoses including hypertension, Parkinson's disease, and unspecified pain, was receiving opioid medication, specifically tramadol, as per the Physician Order Summary and Medication Administration Record. However, there was no care plan in place addressing the resident's pain management needs. The Director of Nursing acknowledged the absence of a care plan during an interview, noting that a recent mock survey had identified issues with care plans. Similarly, Resident 20, diagnosed with dementia and renal cancer, was receiving scheduled opioid medication, Norco, for pain management. Despite the resident's severe cognitive impairment and the administration of opioid medication, there was no care plan related to pain or opioid use. The Director of Nursing confirmed the lack of a care plan during an interview. The facility's policy on comprehensive care plans mandates that a care plan be developed within seven days after the completion of the comprehensive MDS assessment, considering all Care Assessment Areas triggered by the MDS.
Failure to Update and Implement Care Plans for Residents
Penalty
Summary
The facility failed to ensure care plans were implemented and updated for three residents. Resident 44, who was admitted with a surgical wound, cellulitis, and diabetes, had a wound vac ordered for her right leg. However, her care plan did not include interventions related to the wound vac, despite physician orders and observations confirming its use. The Director of Nursing acknowledged that the care plan had not been updated to reflect this change. Resident 21's care plan was not updated to reflect a change in antipsychotic medication. Although the resident was receiving Seroquel, the care plan still referenced Nuplazid, which had been discontinued months earlier. Similarly, Resident 32's care plan was outdated, as it still included melatonin for sleep disturbances, despite the medication being discontinued. The Director of Nursing and the Vice President of Regulatory Compliance both acknowledged the oversight in updating care plans, which was identified during a mock survey.
Failure to Implement Activities for Cognitively Impaired Resident
Penalty
Summary
The facility failed to implement appropriate activities for a cognitively impaired resident, identified as Resident 4, who required assistance with activities of daily living. Observations over several days revealed that the resident was often found lying in bed in a dark room with no music or television playing, despite having a CD player and a television available. The resident's care plan indicated a need for one-to-one activity programming, including listening to Christian music, reading the Bible, and receiving tactile stimulation such as hand massages. However, these activities were not consistently provided, as evidenced by the lack of music or other engagement during the observed periods. The resident's medical history included Alzheimer's disease, delusional disorder, circadian rhythm sleep disorder, and anxiety disorder, which necessitated a structured activity plan to meet her needs. The facility's documentation indicated that one-to-one activities were supposed to occur three times a week, but there was no evidence of activities beyond conversation, music, and television. Interviews with the Director of Nursing and the Activity Director revealed that the resident experienced cycles of wakefulness and sleep, and during her awake periods, music was played for her. However, these interventions were not documented in the care plan, and there was no record of the resident's quiet time or refusal of activities, indicating a lack of comprehensive activity implementation and documentation for the resident's needs.
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Illustrative
What surveyors actually found near you
We read the 114 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Knox
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Miller's Merry Manor | 11.1 mi | ★★★★★ | 15 | 0 |
| Miller's Merry Manor | 13.8 mi | ★★★★★ | 24 | 0 |
| Hickory Creek At Winamac | 15.9 mi | ★★★★★ | 7 | 0 |
| Pulaski Health Care Center | 15.9 mi | ★★★★★ | 24 | 0 |
| Miller's Merry Manor | 16.1 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.