Failure to Provide Oral Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate oral care to two residents who were dependent on staff for activities of daily living. For one resident with a history of poor oral hygiene and dental problems, physician orders and the care plan required oral care every eight hours. Despite this, observations revealed that the resident had visible white/yellow debris and a film on her teeth, and she confirmed that her teeth had not been brushed that morning. The resident's family also reported ongoing concerns about plaque and poor oral hygiene during recent visits. Staff interviews indicated that oral care should be performed daily, but the resident continued to have visible debris in her mouth during multiple observations. Another resident, who was nonverbal and had significant physical impairments including quadriplegia and a persistent vegetative state, also had physician orders for oral care every eight hours. A dental consult had previously documented poor general oral hygiene. During the survey, this resident was observed with yellowish debris between his teeth. The DON confirmed that morning care should include brushing teeth or using a sponge to remove debris, in accordance with the facility's oral hygiene policy. Despite these requirements, both residents did not receive the necessary oral care as ordered and outlined in their care plans.