Mountain Laurel Healthcare: Catheter Care Failures - PA
The citation, issued August 14, covered both catheter care and the management of incontinence more broadly. Inspectors classified it as a pattern, meaning the problem wasn't isolated to a single resident or a single bad day. It reached enough people, in enough instances, to constitute a recurring failure.
Urinary tract infections are among the most common and most preventable complications in nursing home care. For elderly residents, particularly those who are frail or have compromised immune systems, a UTI that goes undetected or untreated can escalate quickly. What begins as discomfort can become a systemic infection. For catheterized residents, the risk is compounded, because a catheter that isn't handled correctly is a direct pathway for bacteria.
The inspectors did not document actual harm. What they documented was a pattern with the potential for more than minimal harm — a distinction that matters in regulatory terms but offers limited comfort to anyone who has watched a family member cycle through repeated infections in a care facility.
Mountain Laurel reported the deficiency corrected as of September 25, roughly six weeks after the inspection.
The catheter finding was one of 14 deficiencies inspectors cited during the August visit. The inspection was conducted in response to a complaint. The report does not identify who filed the complaint or what it alleged.
Fourteen deficiencies in a single inspection is a significant number. The citations span the facility's care practices broadly enough that the catheter finding, despite its pattern-level classification, sits within a larger picture of compliance problems documented in a single visit.
The facility is located in Clearfield, a small city in central Pennsylvania. Mountain Laurel Healthcare and Rehabilitation Center serves residents who need both long-term nursing home care and shorter-term rehabilitation services — a population that often includes people recovering from surgery, stroke, or injury, many of whom may have catheters placed during hospitalization and arrive at the facility still requiring that care.
Catheter-associated urinary tract infections, known in clinical settings as CAUTIs, are widely tracked as a preventable harm. The presence of a urinary catheter increases a patient's risk of developing a UTI substantially, and the risk grows with each additional day the catheter remains in place. Proper care requires consistent attention: keeping the catheter and surrounding area clean, ensuring the drainage bag stays below the level of the bladder, watching for signs of infection, and reassessing regularly whether the catheter is still necessary.
When that care becomes inconsistent across multiple residents, as inspectors found here, the facility's systems for delivering it have broken down somewhere.
The correction date the facility reported, September 25, falls more than a month after the inspection. What changed in those six weeks, and whether the changes will hold, the inspection report does not say.
What it does say is that on the day inspectors walked through the doors of Mountain Laurel Healthcare and Rehabilitation Center, they found a pattern. Not one nurse, not one shift, not one oversight. A pattern. And 13 other problems besides.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Mountain Laurel Healthcare and Rehabilitation Ctr from 2025-08-14 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 20, 2026 · Our methodology
MOUNTAIN LAUREL HEALTHCARE AND REHABILITATION CTR in CLEARFIELD, PA was cited for violations during a health inspection on August 14, 2025.
The citation, issued August 14, covered both catheter care and the management of incontinence more broadly.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.