Laurel Creek Health Center

In the surveyor’s words

From the most serious findings on record at Laurel Creek Health Center, in the surveyor’s own words.

• Actual harm, isolatedF678Jul 8, 2026

  Based on interview and record review, the facility failed to provide care and treatment in accordance with professional standards of practice and resident's needs for Resident 1 by failing to administer oxygen (a life sustaining gas that travels from lungs to the blood and helps convert food into energy), when Resident 1 was found with critically low oxygen levels in the blood (a dangerous, life-threatening condition when the oxygen not reaching body tissues often causing confusion, rapid breathing, and altered level of consciousness-a change in arousal and responsiveness that ranges from mild to severe e.g. lethargy to coma state). […]

• Actual harm, isolatedF686Apr 3, 2024

  Based on interviews and record reviews, the facility failed to ensure one out of two sampled resident (Resident 1) did not develop a pressure ulcer when the facility did not follow their policy and procedure for prevention of pressure injuries such as inspecting the skin daily when performing or assisting with personal care or activities of daily living (ADL, tasks of everyday life), did not continually evaluate Resident 1 ' s potential for skin breakdown per physician ' s order and request a preventative treatment prescribed by the physician once Resident 1 became incontinent of both bladder (the ability to control on when to empty the urine)and bowel function (the ability to control when to have a bowel movement). […]

• Actual harm, isolatedF689Mar 10, 2023

  Based on observation, interview and record review, the facility failed to ensure a resident was free from falls/accidents when they allowed a resident's spouse to ambulate (walk) the resident by herself with no appropriate gait training (helping a patient re-learn to walk safely and efficiently) provided, no return demonstration by the spouse that she could ambulate the resident by herself safely and staff did not follow the fall intervention to ensure a resident's bed height was appropriate as stated in the fall care plan for one out of two sampled residents (Resident 6). […]

• Actual harm, isolatedF689Jul 15, 2022

  Based on interview and record review, the facility failed to mitigate the risk of accidents for one (Resident 1) of the three sampled residents, when Resident 1 fell and facility staff did not document completing an assessment of Resident 1 or determine if new interventions to minimize Resident 1's risk of falling and injury were warranted. This failure did not minimize the fall or injury risks to Resident 1, who suffered a second fall within hours and required transfer to a higher level of care for management of pain and fractures of the left sixth, seventh, eight, ninth and tenth ribs. […]

• No harm, potential for more than minimal, patternF755Apr 17, 2026

  Based on observation, interview, and record review, the facility failed to ensure pharmacy services were maintained for a census of 39 when the controlled drug (a medication that may be abused or cause addiction) record form was not filled out and signed accurately. This failure has the potential to result in diversion of the residents' unused controlled medications.Findings:During an inspection of the Controlled Medication Disposition Log located in a secure locked cabinet at Station 1 on 4/15/26 at 10:25 a.m., the April 2026 Log had a total of five medication entries which coincided with the controlled medication in the bin within the cabinet. […]