Failure to Provide Timely Dental Services
Penalty
Summary
The facility failed to promptly provide dental services for a resident, identified as Resident 89, by not scheduling a dental appointment despite a physician's order for a dental consult. The resident was admitted to the facility with conditions including rheumatoid arthritis, osteoporosis, and generalized muscle weakness. The resident had requested routine dental care from the social services department approximately three months prior but did not receive a response or appointment. The resident's Minimum Data Set indicated intact cognition and required assistance with activities of daily living. Interviews with facility staff revealed that the dentist visits the facility one to two times a month, and residents are seen based on a list provided by the facility. The Social Services Assistant acknowledged that the resident's insurance denied authorization for in-facility dental services, and arrangements for an external appointment were not made. The Social Services Director confirmed the lack of documentation and communication regarding the resident's dental care needs. The facility's policy requires assisting residents in obtaining necessary dental services, including arranging appointments and transportation if needed, which was not adhered to in this case.
Plan Of Correction
F791 Routine/Emergency Dental Services in NFs CFR(s): 483.55(b)(1)-(5) A. How corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice: The Director of Social Services arranged dental services for Resident 89, and she was examined by the dentist on 3/6/2025. B. How the facility will identify other residents having the potential to be affected by the same deficient practice and what corrective action was taken: Residents with dental service needs are potentially affected by the facility practice. The Director of Social Services audited long-term resident records to identify residents who had not been seen by the dentist within the last 12 months on 3/24/25. A total of 47 resident records were reviewed. Three of 47 residents had not been evaluated during the prior 12 months by the dentist. These residents were interviewed to identify any emergent dental needs. No residents requested an emergency dental visit. The Director of Social Services placed residents who had not received an annual routine dental visit on the dentist list for evaluation on 3/28/2025. No other residents were affected by the facility practice. C. What measures will be put into place or what systematic changes the facility will make to ensure that the deficient practice does not recur: The Administrator re-educated the Director of Social Services regarding the facility policy and procedure, "Dental Services," emphasizing that resident requests for dental exams must be scheduled during the next routine dentist visit, as soon as possible if the dental need is emergent, on 3/24/2025. The Director of Social Services will create a log of all residents and their dental visits, including requests for additional services by the dentist when needed. D. How the facility plans to monitor its performance to make sure solutions are sustained: The Director of Social Services will maintain a log of all residents and their dental visits, including requests for additional services by the dentist when needed. The Director of Social Services will use the log to monitor the exams and requests for further dental needs of the residents, including the date the exam is completed and any further follow-up needed. The Director of Social Services will report trends identified in the timely completion of dental visits for residents to the QAPI/QAA Committee at least quarterly for the purpose of process improvement through root cause analysis and committee-recommended interventions to ensure continued compliance with this plan of correction. Allegation of Compliance Date: 3/25/2025 F806 Resident Allergies Preferences Substitutes CFR(s): 483.60(d)(4)(5)