Below average — CMS composite of the measures below.
The next survey window likely opens around October 2026
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 Knollwood Manor during CMS and state inspections, most recent first.
The facility did not report multiple incidents of unexplained injuries—including skin tears, hematomas, abrasions, and discolorations—affecting several cognitively impaired residents, as required by policy and state regulations. Despite documentation of these injuries and internal notifications, the incidents were not reported to the state agency, and the Administrator confirmed that such reporting did not occur.
The facility did not conduct or document required investigations for injuries of unknown origin in six residents with cognitive impairment and multiple comorbidities. Despite policy requiring thorough investigation of incidents such as skin tears, hematomas, and abrasions, the facility was unable to provide investigation records for these events. Interviews with the DON and Administrator confirmed that investigations were not routinely performed or documented, resulting in a deficiency.
The facility did not consistently record daily temperatures for the refrigerator, freezer, and cooler as required by policy, resulting in food being stored and served without proper temperature monitoring. This deficiency affected 38 residents who received food trays during the period when temperature checks were not documented.
The facility did not properly track infections by organism or monitor for outbreaks, and failed to implement Enhanced Barrier Precautions for a resident with wounds. Staff did not post required signage or use appropriate PPE during wound care, despite facility policy and physician orders. Interviews confirmed that infection control protocols were not followed.
The facility did not hold or document required care plan meetings on admission and quarterly for two residents with significant medical conditions, failing to invite or involve the residents or their representatives as required by policy. The DON confirmed that documentation for these meetings was missing or that meetings had not been scheduled or completed.
Failure to Report Injuries of Unknown Origin
Penalty
Summary
The facility failed to report injuries of unknown origin for six residents as required by both facility policy and state regulations. Policy review indicated that any incident of unknown origin or suspicious in nature must be reported to the State of Tennessee within two hours, regardless of the resident's medical conditions. Despite this, multiple incidents involving injuries such as skin tears, hematomas, abrasions, and discolorations were documented in resident records and incident reports without subsequent notification to the state agency. The residents involved were all cognitively impaired to varying degrees, with several being severely impaired and unable to communicate the cause of their injuries. For example, one resident was found with a skin tear to the right forearm of unknown cause, another with a 6-inch hematoma to the left forearm, and others with abrasions or discolorations, all of which were unexplained. In each case, the facility completed internal documentation and notified responsible parties or physicians, but did not report the incidents to the state as required for injuries of unknown origin. During an interview, the Administrator acknowledged that incidents of unknown origin should be reported but admitted that these specific cases were not reported. The Administrator also indicated a reliance on staff trust and did not provide evidence of investigations that would rule out abuse or neglect. This lack of reporting and investigation for injuries of unknown origin constituted a failure to comply with both facility policy and state requirements.
Failure to Investigate Injuries of Unknown Origin
Penalty
Summary
The facility failed to conduct complete and thorough investigations for injuries of unknown origin in six out of eight sampled residents reviewed for abuse. According to the facility's abuse policy, incident reports are required for all resident incidents, including falls, bruising, and skin tears, and each incident must be sufficiently investigated to determine the cause and include comments to prevent further injury. However, for each of the six residents cited, the facility was unable to provide documentation of any investigation accompanying the incident reports for injuries such as skin tears, hematomas, abrasions, and discoloration of unknown origin. The residents involved had significant cognitive impairments, as indicated by low BIMS scores, and multiple comorbidities such as Alzheimer's Disease, cerebral infarction, dementia, and chronic kidney disease. The incidents included findings such as a superficial skin tear, a large hematoma, a 1 cm skin tear, an abrasion, and purple discoloration, all with unknown causes. In each case, the incident was documented, but no investigation records were available to determine the cause or rule out abuse, as required by facility policy. Interviews with the DON and Administrator revealed that investigations into these incidents were either not conducted or not documented. The DON stated that discussions with staff about skin incidents are usually documented and attached to the incident report, but was unable to provide such documentation for the cited cases. The Administrator acknowledged that investigations were not routinely performed for incidents of unknown origin, often attributing injuries to resident behaviors or cognitive status without further inquiry or documentation. This lack of investigation and documentation led to the deficiency cited by surveyors.
Failure to Document Daily Food Storage Temperatures
Penalty
Summary
The facility failed to ensure that food was stored, handled, prepared, and served under sanitary conditions as required by both facility policy and professional standards. Specifically, the facility did not record the temperatures of the refrigerator, freezer, and cooler on multiple days throughout September 2025, as evidenced by a review of the Record of Refrigeration Temperatures. The facility's own policy mandates that the temperature of each freezer and refrigerator be checked and recorded daily to prevent contamination and bacterial growth. However, documentation was missing for several dates for each piece of equipment. During an interview, the Dietary Manager confirmed that temperatures for the refrigerator, freezer, and cooler should be checked and recorded daily. Despite this requirement, the lack of documentation indicates that this process was not consistently followed. As a result, 38 residents received food trays from the kitchen during the period when temperature monitoring was not properly documented.
Failure to Implement and Monitor Infection Control and Enhanced Barrier Precautions
Penalty
Summary
The facility failed to establish and implement an effective infection prevention and control program as required by policy and regulation. The Infection Preventionist (IP)/Director of Nursing (DON) did not track infections by specific organisms, nor did they monitor for outbreaks or cross contamination among residents. Documentation reviewed, including the Nosocomial Infection Summary and Line Listing of Patient Infections, lacked information on the specific organisms involved in infections, and the IP/DON confirmed that such tracking was not performed. Additionally, there was no evidence that the facility monitored for cross contamination or investigated potential outbreaks, even when multiple urinary tract infections (UTIs) occurred on the same hallway within a month. For one resident, who had diagnoses including deep tissue damage, osteomyelitis, and malignant neoplasm of the prostate, the facility failed to implement Enhanced Barrier Precautions (EBP) as ordered by the physician. Observations revealed that EBP signage was not posted on the resident's door, and staff did not consistently use the required personal protective equipment (PPE) during wound care. Specifically, staff entered the resident's room, donned gloves but not gowns, and performed wound care without following the EBP protocol, despite being aware that the resident was under EBP. Interviews with staff, including an LPN and the Assistant Director of Nursing (ADON), confirmed that EBP signage should have been present and that both gown and gloves were required for wound care. The lack of signage and failure to use appropriate PPE during high-contact care activities demonstrated a breakdown in the facility's infection control practices, as outlined in their own policies and job descriptions.
Failure to Hold and Document Required Care Plan Meetings with Resident Participation
Penalty
Summary
The facility failed to ensure that care plan conference meetings were held on admission and quarterly for two residents, as required by both facility policy and federal and state standards. Facility policy mandates that a care plan meeting be held within seven days following a new comprehensive assessment and that these meetings be reviewed and updated at least quarterly, with the resident and/or their representative invited and encouraged to participate. Documentation of the meeting, including participant names and roles, is required, and if the resident or representative chooses not to participate, this must be documented. However, for one resident with diagnoses including traumatic subarachnoid hemorrhage, convulsions, cerebral infarction, and pain, there was no documentation that care plan meetings were held or that the resident or representative was invited following multiple MDS assessments, despite varying levels of cognitive function as indicated by BIMS scores. The care plan for this resident was last reviewed and revised on 9/15/2025, but required documentation for prior meetings was missing. Similarly, another resident with fractures of both femurs and seizures was admitted and had an admission MDS assessment indicating moderate cognitive impairment. The facility was unable to provide documentation that a care plan meeting was held or that the resident or representative was invited following the admission assessment. The care plan for this resident was also last reviewed and revised on 9/15/2025. During an interview, the Interim DON confirmed that she could not provide documentation for the required care plan meetings for either resident and acknowledged that a care plan meeting had not been scheduled or completed for the second resident.
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Illustrative
What surveyors actually found near you
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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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How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Red Boiling Springs Tn Opco Llc | 9.7 mi | ★★★★★ | 7 | 0 |
| Hartsville Convalescent Center | 11.3 mi | ★★★★★ | 1 | 1 |
| Westmoreland Care & Rehab Ctr | 13.4 mi | ★★★★★ | 9 | 0 |
| Smith County Health And Rehabilitation | 17.8 mi | ★★★★★ | 8 | 0 |
| Cal Turner Rehab And Specialty Care | 19.8 mi | ★★★★★ | 2 | 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.