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F0584
D

Failure to Protect Resident's Dentures from Loss

Hemet, California Survey Completed on 04-14-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to exercise reasonable care to protect a resident's personal property, resulting in the loss of the resident's lower dentures. The resident, who had dementia and depression and was assessed as having moderately impaired cognition, reported the dentures missing to a nurse the morning after they were lost. Despite this, the Director of Nursing (DON) was not made aware of the missing dentures until several days later, and there was no immediate search or notification to administration as required by facility policy. The resident expressed distress over the loss, and staff were unable to locate the dentures after the incident. Record review showed that the resident required assistance with denture hygiene and was encouraged to wear dentures. Facility policies required prompt investigation and reporting of lost property, as well as timely referral for dental services if dentures were lost. However, these procedures were not followed, as the loss was not promptly reported to the DON, and there was no documentation of immediate efforts to replace the dentures or ensure the resident's oral health needs were met following the loss.

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