Life Care Center of Puyallup: Oral Care Neglect - WA

Resident 91, who suffers from respiratory failure, pneumonia, asthma, and chronic obstructive pulmonary disease, told inspectors on April 7 that they had not brushed their teeth since arriving at the facility. They said they had no oral care supplies.

The resident repeated the same complaint the next day. Inspectors found no oral care supplies near the sink in their room.

On April 9, inspectors discovered a gray box sitting on a nightstand out of the resident's reach. Inside was a new, unopened toothbrush and unopened travel-sized toothpaste. The resident told inspectors they could not brush their teeth.

Staff N, a certified nursing assistant assigned to care for Resident 91, told inspectors they could not remember whether they had helped the resident with oral care. Staff M, another nursing assistant, said they didn't know about Resident 91's oral care needs because they weren't assigned to that resident.

Staff O, a licensed practical nurse, acknowledged that oral care supplies should be easily available and that staff were expected to help residents with oral care.

The facility's Director of Nursing Services confronted the resident about the complaint. Staff B told Resident 91 they had seen them brush their teeth. The resident responded, "No, you did not."

Administrator Staff A told inspectors that oral care should be provided daily according to each resident's preferences.

The violation placed Resident 91 at risk for decreased self-worth, oral infection, and diminished quality of life, according to the inspection report. The resident's underlying respiratory conditions, including pneumonia and COPD, made proper oral hygiene particularly important for preventing additional infections.

Federal inspectors found the facility failed to ensure basic oral care for the resident over multiple days in April. The resident was able to communicate their needs but required assistance with activities of daily living.

The nursing assistant responsible for Resident 91's care could not recall providing oral hygiene assistance. Other staff members said they were unaware of the resident's needs or weren't assigned to provide that care.

Meanwhile, the supplies needed for basic dental hygiene sat unopened and inaccessible just feet away from the resident who repeatedly asked for help.

The inspection occurred from April 7 through April 10. Resident 91 had been admitted to the facility with multiple serious respiratory conditions that can worsen without proper oral care.

Staff described a system where nursing assistants were supposed to help residents who couldn't perform oral care independently and set up supplies for those who could manage the task themselves. But that system failed Resident 91, who spent days unable to brush their teeth while staff either forgot, didn't know, or weren't assigned to help.

The facility's administrator said oral care should happen every day based on resident preferences. The Director of Nursing said staff were expected to assist with oral care and supplies should be easily available.

Yet Resident 91's toothbrush and toothpaste remained sealed in their original packaging, sitting on a nightstand beyond reach while the resident repeatedly told inspectors they had no way to brush their teeth.

When the nursing director finally entered the resident's room to address the complaint, they insisted they had seen the resident brush their teeth. Resident 91 contradicted that claim directly.

The case illustrates how basic care can break down when staff fail to communicate about resident needs or ensure supplies are accessible to those who need assistance with daily activities.

Full Inspection Report

The details above represent a summary of key findings. View the complete inspection report for Life Care Center of Puyallup from 2026-04-10 including all violations, facility responses, and corrective action plans.

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