The Laurels of Hendersonville

In the surveyor’s words

From the most serious findings on record at The Laurels of Hendersonville, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 17, 2024

  Based on record review, and interviews with staff, Medical Director, and Medical Examiner, the facility failed to ensure Resident #1 was supervised during a shower. On 11/18/24 Nurse Aide (NA) #1 had Resident #1, who had dementia and impulsiveness, in the shower room in his unlocked wheelchair. Resident #1 removed his shoes and was removing his shirt when NA #1 turned her back and stepped away from Resident #1 to go to a linen cabinet. When NA #1 turned around, Resident #1 stood up from his wheelchair, lost his balance and fell . Resident #1 immediately verbalized pain. He was transferred to the Emergency Department (ED) and was diagnosed with a right femoral neck (thigh bone) fracture that required surgical repair. […]

• Immediate jeopardy, isolatedF600Nov 20, 2023

  Based on observations, record review, and resident, family, staff, Physician Assistant, Guardian, Pastor, Psychiatric Nurse Practitioner, Psychotherapist, Law Enforcement, and Health Care Personnel Investigator interviews, the facility failed to protect a vulnerable female resident (Resident #1) from inappropriate sexual advances from an employee (Med Aide #1) for 1 of 3 residents reviewed for abuse. On 10/19/23, Resident #1 alleged Med Aide #1 had kissed her, touched her legs and breasts and exposed his penis to her which also had the high likelihood of placing other vulnerable residents at risk of abuse. […]

• No harm, potential for more than minimal, patternF761Jun 5, 2026

  Based on observations and staff interviews, the facility failed to remove expired and discontinued medications from 3 of 5 medication carts reviewed for medication storage (100 hall cart, 200 hall upper medication cart, and 200 hall lower medication cart).a. An observation on 6/5/26 at 10:14 AM with the Director of Nursing (DON) of the 200-hall upper medication cart revealed a medication card of Pantoprazole 40 milligram (mg) tablets that had a total of 27 pills left marked with an expiration date of 5/31/26 from the pharmacy. Review of the physician's order for Pantoprazole revealed that it had been discontinued on 3/9/26. Pantoprazole is used to treat gastroesophageal reflux disease (a condition that causes excess stomach acid). […]

• No harm, potential for more than minimal, patternF565Jan 5, 2024

  Based on record review, resident and staff interviews, the facility failed to resolve and communicate the facility's efforts to address repeated concerns voiced by residents during Resident Council meetings for 6 of 7 months reviewed (June 2023, July 2023, August 2023, September 2023, October 2023, and November 2023). Findings included: The Resident Council minutes for the period June 2023 through December 2023 were reviewed and revealed the following: Resident Council minutes dated 06/13/23 noted in part, old business was noted as read and approved and any issues not resolved were moved to new business. […]

• No harm, potential for more than minimal, patternF584Jan 5, 2024

  Based on observations and staff interviews the facility failed to maintain clean overbed tables (room [ROOM NUMBER]); maintain clean ceiling vents (bathroom of 104, 107, 112); maintain walls in good repair (rooms 104, 107, 205, and 207); maintain clean privacy curtains (rooms 106, 107, 112 and 205); maintain a clean bedside commode (shared bathroom of 107); and maintain a clean mechanical lift (lift for 100 and 200 halls) for 2 of 4 halls reviewed for environment (100 hall and 200 hall). Findings included: 1. An observation of the walls in rooms 205 on 01/02/2024 at 11:22 AM revealed a screw sticking out of the wall next to the window. […]