Inspection Reports for
Brickyard Healthcare – Muncie Care Center

The facility was found in compliance with Emergency Preparedness Requirements but was found not in compliance with Life Safety Code requirements, including issues with exit door accessibility, exit discharge surfaces, exit signage, hazardous area door closures, and corridor door smoke resistance.

The facility was found deficient in multiple areas including failure to ensure proper consent signatures, failure to notify physicians of elevated blood pressures, failure to notify the Ombudsman of hospitalizations, failure to provide bed hold policy notifications, inadequate catheter care, failure to follow dietitian recommendations for weight loss, improper feeding tube care, incorrect oxygen administration, inadequate dementia care interventions, incomplete narcotic reconciliation, improper insulin labeling, and failure to offer pneumococcal and COVID-19 vaccines per CDC guidelines.

Complaint IN00451341 had no deficiencies related to allegations. Complaints IN00451394 and IN00451774 had federal/state deficiencies cited at F684 related to medication administration outside physician ordered parameters.

The facility failed to follow physician-ordered parameters for blood pressure medication administration for 1 of 3 residents reviewed, resulting in medication being given outside prescribed parameters without proper documentation or indication. Three out of 17 residents with blood pressure medication parameters were affected by this deficient practice.

The facility was found in compliance with Emergency Preparedness Requirements but was found not in compliance with Life Safety Code requirements due to failure to maintain means of egress free from obstructions in one corridor, specifically due to small plastic three drawer chests without wheels obstructing the corridor.

Complaint IN00436377 - No deficiencies related to the allegations are cited. Complaint IN00436684 - Federal/state deficiencies related to the allegations are cited at F690. Complaint IN00437298 - No deficiencies related to the allegations are cited.

The facility was found deficient in multiple areas including failure to complete timely Significant Change Minimum Data Set (MDS) assessments, failure to maintain urinary drainage devices properly, failure to monitor fluid restrictions for dialysis patients, inadequate infection prevention and control practices including improper use of enhanced barrier precautions, failure to implement an antibiotic stewardship program, and lack of a qualified Infection Preventionist.

Complaint IN00414267 was substantiated with federal/state deficiencies cited at F600, F607, and F609. Complaint IN00413854 had no deficiencies related to the allegations.

The facility failed to timely report allegations of abuse involving multiple residents and staff, and failed to report accurate information regarding some allegations. Specific incidents included rough handling and abuse by CNA 6 of Residents B and D, and an altercation involving Residents C and E. LPN 19 was suspended for failure to report abuse allegations promptly. The facility implemented corrective actions including staff education, audits, and monitoring to prevent recurrence.

Complaint IN00410284 - No deficiencies related to the allegations are cited. Complaint IN00410288 - Federal/State deficiencies related to the allegation are cited at F659 (medication administration by unqualified QMAs). Complaint IN00410832 - No deficiencies related to the allegations are cited.

The facility failed to ensure that Qualified Medication Aides (QMAs) who were not insulin-certified administered insulin to 6 residents. Additionally, the facility failed to provide adequate supervision and interventions to prevent two residents from leaving the facility property without staff knowledge.

The facility was found not in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, specifically failing to conduct required emergency plan exercises twice per year including unannounced staff drills, and not conducting annual 90-minute battery backup emergency light testing. Additionally, a multi-plug adaptor was found in use in a resident room, which is not compliant with electrical safety codes.

The facility was found deficient in several areas including failure to resolve resident council concerns about long call light wait times, failure to protect residents from sexual abuse, failure to follow physician orders for medication administration, failure to properly manage urinary catheters, failure to implement behavioral programming for sexually inappropriate behaviors, and medication administration errors related to insulin pen priming.

Complaint IN00403360 was investigated, with deficiencies cited related to failure to notify resident representative of new psychotropic medication and failure to ensure appropriate indication for psychotropic medication use.

The facility failed to ensure the resident representative was notified when a new psychotropic medication was started for one resident (Resident B). Additionally, the facility failed to ensure that a new psychotropic medication had an appropriate indication for use for the same resident. Resident B had behaviors including touching other residents and was started on Paxil without proper notification and documentation.

Complaint IN00401123 was substantiated with deficiencies cited at F600. Complaint IN00401809 was substantiated with deficiencies cited at F600 and F607. Complaint IN00402249 was substantiated but no deficiencies were cited related to the allegations.

The facility was found to have substantiated complaints related to abuse and neglect involving staff and resident interactions, including physical abuse by a staff member and sexually inappropriate behaviors between residents. The facility failed to ensure timely reporting of abuse allegations. Corrective actions were completed prior to the survey.

Complaint IN00394960 - Substantiated with no deficiencies cited. Complaint IN00397076 - Substantiated with federal/state deficiencies cited at F689.

The facility failed to ensure adequate supervision and individualized interventions to prevent falls for one resident (Resident D). The resident had multiple falls, including a fall resulting in a fractured hip, and the care plan was not adequately updated with additional interventions to reduce fall risk until after the incidents. The facility implemented corrective actions including audits, education, and ongoing monitoring to prevent recurrence.

Complaint IN00389256 - Substantiated with no deficiencies cited. Complaint IN00389435 - Substantiated with no deficiencies cited. Complaint IN00389228 - Substantiated with federal/state deficiencies cited at F684 related to quality of care.

The facility failed to ensure a resident admitted with a suprapubic catheter received appropriate catheter care in accordance with professional standards upon admission. Specifically, catheter care orders were missing for eight days, and the facility did not obtain necessary orders or document catheter care, resulting in the resident being sent to the hospital for evaluation and treatment.