LAUREL, MS - State health inspectors documented serious violations at Laurelwood Community Living Center during an April 2025 survey, including a resident who was hospitalized with fecal impaction after going six consecutive days without a documented bowel movement while staff continued administering anti-diarrheal medication. The inspection also revealed failures in basic hygiene protocols and active pest infestations in the facility's kitchen.
Resident Hospitalized After Six Days Without Bowel Movement Documentation
The most serious violation involved a 78-year-old female resident who required emergency hospitalization for fecal impaction after facility staff failed to monitor, document, or address her bowel function for extended periods. According to inspection records, the resident went without a documented bowel movement for six consecutive days in January 2025 (January 14-19), yet nursing staff continued administering Lomotil, an anti-diarrheal medication, three times daily throughout this period.
The resident's daughter told inspectors that her mother "had been hospitalized in January because she did not have a bowel movement for a week" and required transfer to an out-of-state hospital where she remained for nearly a week due to impacted bowels. Hospital records confirmed the resident was treated from January 30 through February 4, 2025, for multiple medical issues including diagnosed fecal impaction.
Investigation revealed multiple systemic failures in the facility's bowel management protocols. The facility acknowledged it had no written policy for constipation management or bowel movement monitoring. While nurses reported receiving computer alerts when residents go three consecutive days without a bowel movement, no such interventions were documented for this resident despite gaps of three, four, and six consecutive days without recorded bowel movements throughout January.
The resident's physician told inspectors he was unaware that she had gone six consecutive days without a bowel movement prior to hospitalization. He confirmed that had he been notified, he would have implemented orders for constipation management. The Director of Nursing admitted there was "no documentation of nursing interventions, constipation medications administered, or provider notification regarding the gaps in bowel movements prior to the hospitalization."
Medical Significance of Bowel Management Failures
Fecal impaction represents a serious medical emergency that develops when hardened stool becomes lodged in the colon or rectum, preventing normal bowel movements. The condition can cause severe abdominal pain, rectal bleeding, and in severe cases, bowel perforation or sepsis. For elderly nursing home residents, particularly those with cognitive impairment or communication difficulties, regular bowel monitoring becomes critical as they may be unable to report discomfort or constipation symptoms.
The continued administration of anti-diarrheal medication while a resident experiences constipation compounds the problem significantly. Lomotil works by slowing intestinal movement, which can worsen existing constipation and accelerate impaction formation. Standard medical protocol requires immediate discontinuation of anti-diarrheal medications when constipation is suspected, along with implementation of bowel management interventions such as stool softeners, laxatives, increased fluids, and dietary modifications.
The facility's standing orders included MiraLax, a commonly used laxative, available on an as-needed basis. However, records showed this medication was never administered to the resident during the critical January period despite multiple days without bowel movements. This represents a fundamental breakdown in clinical assessment and intervention that directly contributed to the resident's preventable hospitalization.
Infection Control Violations During Incontinence Care
Inspectors observed critical lapses in basic hygiene protocols when a certified nurse aide failed to clean a cognitively impaired resident during an incontinence brief change. The aide removed a urine-soaked brief and immediately applied a clean one without performing any perineal cleansing, despite disposable wipes being readily available on the bedside table.
When questioned, the aide acknowledged understanding the proper procedure and recognized that "failing to cleanse the resident could contribute to urinary tract infections and skin breakdown." The facility's written policy explicitly required staff to clean the perineal area with soap and warm water, rinse thoroughly, and dry completely before applying a fresh brief.
This violation carries significant health implications. Prolonged contact with urine and fecal matter creates an ideal environment for bacterial growth, dramatically increasing risks of urinary tract infections, which are already the most common infection in nursing home settings. For elderly residents, UTIs can quickly progress to serious complications including sepsis, delirium, and kidney infection. Additionally, moisture and bacteria trapped against the skin accelerates breakdown, potentially leading to painful pressure sores that can become infected and difficult to heal.
Active Pest Infestation Threatens Food Safety
Perhaps most alarming were the extensive pest control failures documented in the facility's kitchen. During the initial tour, inspectors found rat droppings and shredded cardboard inside a box of individually packaged cereal in the dry storage area. A glue trap smeared with peanut butter was discovered on the pantry floor, indicating ongoing rodent activity.
The situation escalated during meal service when "a live roach was observed crawling across a resident's meal tray" during the assembly line plating process. The contaminated tray was witnessed by multiple staff members including the Dietary Manager, Head Cook, and Maintenance Supervisor before being removed from service. The following day, another live roach was observed crawling on the facility's dishwashing equipment.
Investigation revealed the facility had been battling both rodent and roach infestations for months. Pest control logs documented ongoing activity during monthly treatments in January, February, and March 2025. The Maintenance Supervisor identified a gap under the kitchen's back door as a likely entry point for rodents, acknowledging that staff had been leaving doors open for ventilation due to air conditioning failures.
Additional Issues Identified
Beyond the major violations, inspectors documented several other concerning findings. The facility failed to maintain secure medication storage when a wound care cart containing potentially harmful substances was left unlocked and unattended in a hallway for approximately 20 minutes. The cart contained items including isopropyl alcohol wipes, Santyl ointment, betadine, and other supplies that could cause poisoning if accessed by confused residents.
The Administrator acknowledged being unaware of the kitchen pest issues and attributed oversight failures to high staff turnover. The Registered Dietitian, who conducted monthly kitchen inspections, reported not observing pest activity during her walk-throughs, raising questions about the thoroughness of routine monitoring.
Industry Standards and Required Protocols
Federal regulations require nursing homes to maintain comprehensive policies for monitoring and managing bowel function, particularly for residents with known gastrointestinal issues or those receiving medications affecting bowel motility. Standard protocols mandate daily documentation of bowel movements, prompt intervention when patterns change, and immediate physician notification when initial interventions fail.
For infection control, facilities must ensure all direct care staff receive proper training in hygiene protocols and consistently follow established procedures. This includes thorough cleansing during each incontinence episode, proper hand hygiene, and appropriate use of barriers and protective equipment.
Food safety regulations require facilities to maintain pest-free environments through regular professional treatments, proper food storage, immediate removal of contaminated items, and structural maintenance to prevent pest entry. The presence of live insects on food service equipment and meal trays represents an immediate threat to resident health and violates fundamental sanitation standards.
These violations at Laurelwood Community Living Center demonstrate breakdowns in multiple critical systems designed to protect vulnerable residents. The facility's failure to monitor basic bodily functions, maintain hygiene standards, and ensure food safety created preventable risks that resulted in at least one serious hospitalization and exposed all residents to potential foodborne illness and infection.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Laurelwood Comm Living Center from 2025-04-10 including all violations, facility responses, and corrective action plans.
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