F0677

D

Failure to Provide Ordered and Care-Planned Oral Hygiene Assistance

Wichita, Kansas Survey Completed on 03-04-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide necessary staff assistance with oral hygiene for a resident with multiple sclerosis and severe cognitive impairment. The resident’s MDS documented dependence on staff for oral hygiene, and the care plan directed that he required supervision and partial/moderate assistance with eating and moderate assistance for oral hygiene, with staff to encourage and/or assist with oral care in the morning and evening. Physician orders required staff to offer to brush the resident’s teeth twice daily, every shift. Dental consultant summaries documented that the resident had missing lower right teeth, heavy food debris, moderate to severe gum inflammation, and poor oral hygiene, while remaining cooperative with cleanings. The dentist left written directions for staff to remind and/or assist the resident with brushing twice daily, focusing on the gumline.

Surveyor observations and interviews showed that these ordered and care-planned oral care interventions were not consistently carried out. During morning care, staff assisted the resident but did not offer oral care, and later observation revealed the resident’s toothbrush and toothpaste were present but dry. The resident’s representative reported concerns that staff were not performing oral care as they should and stated she had raised these concerns at a recent care plan meeting. A licensed nurse acknowledged that he did not personally provide oral care but signed it off on the treatment record and then followed up with aides, while a CNA reported she usually did the resident’s oral care after breakfast but had forgotten to do it that day, confirming the resident could not brush his own teeth. The facility’s oral health care policy required oral care twice daily for every resident, but this was not followed for this resident.