Failure to Provide Timely Dental Services
Penalty
Summary
The facility failed to promptly assist residents in obtaining routine dental services, resulting in unmet dental needs for three residents. For one resident, physician orders indicated a referral to the dentist for a dental exam due to complaints of tooth and gum pain, but there was no documentation of a dental exam or follow-up in the progress notes, and the resident reported not having seen a dentist in over five years despite ongoing dental issues. Another resident had a physician order for denture placement and expressed a desire for new dentures, but there was no evidence that the referral was made within three days or that the resident was seen by a dentist, even though the resident reported discomfort from a broken tooth and requested denture adjustment. A third resident expressed the need for a dental cleaning and had not seen a dentist in over a year, despite a care plan indicating poor dental condition and a request for dentures. There was no documentation of a dental referral or appointment for this resident, and the last recorded dental visit was over a year prior, during which a new cavity was noted. Interviews with staff revealed confusion regarding responsibility for making dental referrals, with some believing it was the nurse's responsibility and others indicating it was the social worker's role. The social worker, who had started six months prior, was unclear about the previous dental provider and had only recently secured a new dental contract, but as of the time of the survey, no dental visits had occurred under the new arrangement. Facility leadership, including the DON and administrator, confirmed that social services was responsible for dental appointments and acknowledged delays in securing a dental contract and arranging dental visits. The facility's policy required routine and emergency dental services to be available in accordance with residents' assessments and care plans, with social services responsible for assisting with appointments. However, the lack of timely referrals and absence of dental services for the residents reviewed demonstrated a failure to meet these requirements.