Laurels of Gahanna: Dialysis Care Failures - OH
The Laurels of Gahanna violated federal dialysis care standards during incidents involving residents who depended on the blood-filtering treatments to survive their kidney failure, according to an August inspection report.
Resident 108 had been scheduled for hemodialysis three times weekly on Tuesdays, Thursdays, and Saturdays since late April. The 108-year-old man suffered from multiple serious conditions including muscle weakness, end-stage renal disease, diabetes, a fractured sacrum, pressure ulcers on his left ankle and heel, lung disease, alcohol abuse, and peripheral vascular disease.
His cognitive assessment showed moderately impaired thinking.
On May 10, the resident refused his scheduled dialysis appointment "due to agitation and discomfort," nursing notes show. Staff documented the refusal but took no further action.
Nobody educated him about what would happen if he continued skipping the treatments that kept toxins from building up fatally in his blood.
The facility's Director of Nursing told inspectors that when residents refuse dialysis, "nursing should educate them on the risks and benefits of refusal." That didn't happen.
Resident 102 presented similar problems. The man had been admitted in early June with end-stage renal disease requiring dialysis dependency, cognitive communication deficits, moderate protein-calorie malnutrition, and diabetes. His care plan specifically noted a "history of noncompliance with hemodialysis."
Staff knew he might refuse treatments.
On June 27, he did exactly that. Progress notes documented the refusal, but nursing staff never contacted his family to inform them their relative had declined life-sustaining medical care.
The Director of Nursing acknowledged to inspectors that facility policy required staff to "educate the resident and notify the family" when dialysis is refused.
Neither resident received the required response.
The violations reveal systemic problems with how the 107-bed facility manages dialysis care. Resident 108's care plan contained only generic language about "encouraging him to go for the scheduled appointments" and watching for complications, but included no specific details about where he received dialysis, contact information for the dialysis center, or his exact treatment schedule.
The MDS Nurse who reviewed his case confirmed the care plan "was not specific to the resident."
For people with end-stage renal disease, dialysis typically means the difference between life and death within days or weeks. The treatments remove waste products and excess fluid that healthy kidneys would normally filter from blood. Without dialysis, toxins accumulate rapidly, causing symptoms including nausea, confusion, difficulty breathing, and ultimately coma and death.
Residents 102 and 108 both had documented cognitive impairments that could affect their ability to understand the consequences of refusing treatment. Federal regulations require nursing homes to ensure residents with diminished capacity receive appropriate education and support when making medical decisions.
The facility's interventions for Resident 102 included a directive to "remind him of the consequences and document on it" if he chose not to follow recommended treatment. But when he actually refused dialysis on June 27, staff failed to follow their own protocols.
Family notification becomes particularly critical when residents have cognitive impairments that might compromise their decision-making capacity. Resident 102's comprehensive assessment documented his "impaired cognition," yet his family remained unaware he had refused life-sustaining treatment.
The inspection occurred as part of complaint investigations numbered 2574352 and 2580593, suggesting family members or others had raised concerns about dialysis care at the facility.
Both residents required complex medical management beyond their kidney disease. Resident 108 battled pressure wounds on his heel and ankle, along with deep tissue damage, while managing diabetes, lung disease, and the aftermath of a fractured tailbone. His care demanded careful coordination between the nursing home and his dialysis center.
Resident 102's malnutrition added another layer of complexity to his treatment. Poor nutritional status can complicate dialysis and affect a patient's ability to tolerate the lengthy treatments, which typically last three to four hours and can leave patients exhausted.
The facility's generic care planning approach meant staff lacked specific guidance for managing these complex cases. Without clear protocols for contacting the dialysis center, tracking missed appointments, or escalating refusals, residents fell through cracks in the system.
The Director of Nursing's acknowledgment that staff should educate patients and notify families suggests the facility had policies in place but failed to implement them consistently. This gap between written procedures and actual practice put vulnerable residents at risk.
Federal inspectors classified the violations as causing "minimal harm or potential for actual harm," but the consequences of untreated end-stage renal disease can escalate rapidly. Missed dialysis treatments can lead to dangerous fluid buildup, electrolyte imbalances, and toxic accumulation of waste products.
For residents with cognitive impairments, the stakes are even higher. They may not recognize worsening symptoms or understand why they feel increasingly unwell after missing treatments.
The violations affected two of the three residents reviewed for dialysis care, indicating problems were not isolated incidents but reflected broader systemic issues with how the facility manages this critical aspect of medical care.
Resident 108 was eventually discharged on June 24, nearly two months after his admission and six weeks after his documented refusal. His medical record does not indicate whether he resumed dialysis treatments or continued refusing them.
Resident 102 remained at the facility as of the August inspection, with his family still unaware of his June 27 refusal to attend dialysis.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for The Laurels of Gahanna from 2025-08-20 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
THE LAURELS OF GAHANNA in COLUMBUS, OH was cited for violations during a health inspection on August 20, 2025.
Resident 108 had been scheduled for hemodialysis three times weekly on Tuesdays, Thursdays, and Saturdays since late April.
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.