Allure of Knox County

In the surveyor’s words

From the most serious findings on record at Allure of Knox County, in the surveyor’s own words.

• Immediate jeopardy, patternF600May 14, 2025

  Based on observation, interview, and record review the facility failed to prevent resident physical abuse after (R1) displayed increased agitation and aggression and no interventions were implemented to prevent potential resident abuse for one (R3) of 23 residents reviewed for abuse in the sample of 26. These failures resulted in R1 physically shoving a trash can in R3's face and R3 sustaining a bleeding laceration to upper and lower lips. These failures have the potential to affect all 19 residents (R2, R3, R9 through R25) residing in the facility's Dementia unit. These failures resulted in an Immediate Jeopardy that began on 4/13/25. While the Immediate Jeopardy was removed on 5/13/25, the facility remains out of compliance at a severity level two. […]

• Immediate jeopardy, isolatedF689Sep 13, 2025

  Based on observation, interview, and record review the facility failed to provide immediate and adequate supervision after a resident's family member notified facility staff of a resident voicing R1 was going to escape out of his window and implement 15-minute visual checks as directed by the plan of care, for a cognitively impaired resident at risk for elopement for one (R1) of three residents reviewed for elopement in a sample of three. These failures resulted in (R1) a cognitively impaired resident with a previous elopement attempt from the facility, exiting the facility through his room window without staff knowledge or supervision on 9/3/25. (R1) was found across the road from the facility, a block away and close to active railroad tracks. […]

• Immediate jeopardy, isolatedF580Nov 12, 2021

  Based on interview and record review, the facility failed to notify the Physician of cloudy urine (symptoms of a urinary tract infection) and a significant decline in a resident's mental and physical condition for one of three residents (R1) reviewed for change in condition in the sample of five. These failures resulted in R1 experiencing a change in condition which required hospitalization and subsequently being diagnosed with [CONDITION(S)] (a life-threatening condition which occurs when the body's response to an infection damages its own tissues). R1 expired on [DATE] and a cause of death was identified as [CONDITION(S)]. These failures resulted in an Immediate Jeopardy. While the immediacy was removed on [DATE], the facility remained out of compliance at Severity Level 2. […]

• Immediate jeopardy, isolatedF690Nov 12, 2021

  Based on observation, interview and record review, the facility failed identify and assess the medical justification for R1's catheter use, identify and monitor R1's signs and symptoms of a urinary tract infection, and failed to implement appropriate interventions when R1's urine became cloudy and R1 experienced increased lethargy, decreased communication and changes in skin integrity (R1). The facility also failed to obtain Physician orders [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• Actual harm, isolatedF760Aug 29, 2025

  Based on observation, interview and record review the facility failed to ensure one resident (R4) was free of significant medication error of three residents reviewed for medications. This failure caused R4 to be visibly uncomfortable and anxious. The Facility's undated Medication Errors policy documents Medications errors, once identified will be evaluated to determine if considered significant or not by utilizing the following three general guidelines: a. Resident's condition: if the resident's condition requires rigid control, such as strict intake and out put measurement, daily weights, or monitoring of lab values. b. […]