Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

KNOLLWOOD MANOR

LAFAYETTE, TN · 49 certified beds · Last Life Safety survey July 14, 2022

CMS Certification Number 445410 · first certified March 1998

Ownership

Independently operated (no chain recorded by CMS) · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

7
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
2
Inspection & testing records
Of the citations on file

Position within TN

7 citations — more than 45% of the 303 certified nursing homes in TN. Compared within TN rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Slippingmore citations at the latest survey than at its earlier surveys in the window.

The latest survey found 0 citations; the earlier surveys in the window averaged 3.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Past the typical window (October 2023 to March 2026). Most TN facilities have been surveyed by June 2027. This facility’s last Life Safety survey was July 2022. Facilities in TN are typically surveyed 15–44 months after the last one (median 33), measured over 279 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

Emergency preparedness

3 of the 7 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

2 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 7 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

How that compares

Citations on file over three years

Compared with the median facility in TN, and nationally. Surveyors differ markedly between states, so the TN figure is the meaningful one.

This facility7TN median8National median11
Citations on file over three years, compared
MeasureCitations
This facility7
Median facility in TN8
Median facility nationally11

Survey history

Citations at each Life Safety survey
22018-1152019-0802022-07
Citations at each Life Safety survey
Survey dateCitations
November 15, 20182
August 27, 20195
July 14, 20220

Most-cited tags

Most-cited tags at this facility
K-03531E-00151E-00321K-03241E-00301K-09211K-03511
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.12018-11-15
E-0015Address subsistence needs for staff and patients.12019-08-27
E-0032Provide primary/alternate means for communication.12019-08-27
K-0324Provide properly protected cooking facilities.12019-08-27
E-0030List the names and contact information of those in the facility.12019-08-27
K-0921Ensure that testing and maintenance of electrical equipment is performed.12019-08-27
K-0351Install an approved automatic sprinkler system.12018-11-15

What the citations cover

Citations by CMS category
  • Emergency Preparedness Deficiencies 3
  • Smoke Deficiencies 3
  • Gas, Vacuum, and Electrical Systems Deficiencies 1
Citations by CMS category
CategoryCitations
Emergency Preparedness Deficiencies3
Smoke Deficiencies3
Gas, Vacuum, and Electrical Systems Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

August 27, 2019 — 5 citations

Citations issued on August 27, 2019
TagWhat the surveyor checksStatus
E-0015Address subsistence needs for staff and patients.Deficient, Provider has date of correction (October 11, 2019)
E-0030List the names and contact information of those in the facility.Deficient, Provider has date of correction (October 11, 2019)
E-0032Provide primary/alternate means for communication.Deficient, Provider has date of correction (October 11, 2019)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (October 11, 2019)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (October 11, 2019)

November 15, 2018 — 2 citations

Citations issued on November 15, 2018
TagWhat the surveyor checksStatus
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (December 30, 2018)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (December 30, 2018)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.