Failure to Provide Timely Dental Services
Penalty
Summary
The facility failed to assist residents in obtaining routine and emergency dental care for two of three residents reviewed. One resident, who had diagnoses including dysphagia, obesity, and dehydration, was cognitively intact and dependent on staff for activities of daily living. This resident expressed a need for full upper dentures, and the in-house dentist recommended dentures and required impressions. However, the follow-up appointment for impressions was never scheduled by the responsible LPN, who delayed the process due to uncertainty about the resident's length of stay. The resident remained in the facility and did not receive the necessary dental care, despite the dentist's expectation that the process should have begun at the next available appointment. Another resident, with diagnoses including gastroesophageal reflux disease, anxiety, and dental caries, was also cognitively intact and independent with activities of daily living. This resident was identified as needing a dental consult and subsequently required extraction of a fractured tooth. Orders were placed for a dental consult and extraction, but the extraction was not scheduled or completed. The LPN responsible for scheduling did not follow up after placing the order, and the ward clerk cited issues with the resident's insurance as a reason for the delay in arranging the outside dental appointment. The resident reported ongoing pain and had not received the necessary dental care. Interviews with staff confirmed that there were lapses in scheduling and follow-up for dental services, including delays due to administrative decisions and insurance issues. Both residents did not receive timely dental interventions as recommended by dental professionals, and the processes for arranging and following up on dental care were not consistently implemented.