Failure to Assist Resident with Necessary Dental Care
Penalty
Summary
The facility failed to assist Resident 52 in obtaining necessary dental care, specifically the extraction of upper teeth to facilitate the creation of a full-upper denture. Despite a dental consultation conducted on October 21, 2024, which recommended full mouth x-rays (FMX) and an oral surgery consult for extractions, these recommendations were not followed up. As of February 5, 2025, Resident 52 had not received the required dental x-rays or any consultation order for the extraction of his upper teeth. The deficiency was further compounded by the facility's process, where the physician reviews a 'Visit Summary' document to provide orders. This document did not include the specific recommendations from Resident 52's individual dental consultation form, leading to a lack of further treatment or consultation. Resident 52, who has hypertension and diabetes mellitus type two, reported issues with a partial top denture that moved around while eating, indicating a need for the recommended dental procedures.
Plan Of Correction
1. R52 currently resides at the facility and has been added to the recommended identified contracted dental center for the resident's individual dental consult sheet of dental x-rays and surgical consult for extraction of teeth by March 14, 2025. 2. The facility has determined that all residents have the potential to be affected by this deficient practice. Current residents will be reviewed by the DON and Shift Supervisors to ensure that routine dental services are provided when needed and by March 14, 2025. 3. Re-education will be provided by DON to the licensed nursing staff to include routine and emergency dental services per policy by March 14, 2025. 4. DON and Nurse Supervisors will conduct an audit of at least 5 random residents to determine if dental services have been received as necessary. These audits will be done weekly x4 weeks and then monthly x2 until substantial compliance is achieved or as determined by the findings reported at the monthly and quarterly QAPI meeting until consistent compliance has been met.