Failure to Provide Effective Oral Hygiene Care for Dependent Resident
Penalty
Summary
The facility failed to provide effective oral hygiene care for a resident who was dependent on staff for all activities of daily living, including oral care. The resident had significant medical conditions, including dysphagia, a gastrostomy tube, and malnutrition, and was assessed as having severely impaired cognitive skills and poor memory. The care plan specified that oral care should be provided three times daily, but observations revealed the resident had a tan substance on her teeth, dry lips, and a substance on her reddened, swollen tongue. Interviews with staff indicated that oral care was being performed only twice daily, and the CNA acknowledged that the resident's mouth had appeared in poor condition for some time. The RN confirmed the poor state of the resident's mouth and indicated that such a condition would warrant notifying a physician and seeking further interventions. The dental hygienist, who had seen the resident recently, noted difficulty in providing care due to the resident's lack of cooperation and was unable to confirm whether consistent oral care was being provided. Subsequent observations showed some improvement in the resident's oral condition, but documentation and interviews confirmed that the facility's policy of maintaining moist lips and oral tissues and preventing oral infection was not consistently followed. The DON stated that daily oral care is especially important for residents with g-tubes and acknowledged that the observed condition of the resident's mouth was unacceptable.