Failure to Provide Routine Dental Services to Medicaid Resident
Penalty
Summary
The facility failed to provide routine dental services to a Medicaid-funded resident who was identified as being at risk for oral health problems due to poor dentition. The resident reported having only three teeth, with the upper tooth causing occasional pain and difficulty chewing. Despite a care plan noting the presence of obvious caries and the need for dental consults or referrals, there was no evidence in the medical record that any dental consults had been obtained since the resident's admission. The resident's MDS assessment also indicated the presence of obvious or likely cavities or broken natural teeth. Interviews and record reviews revealed that the resident was scheduled to be seen by the facility's dental provider but was not seen as planned. After missing the scheduled appointment, the resident was not placed back on the dental provider's list for subsequent visits, despite the provider visiting the facility every three months. The facility's policy requires annual oral inspections and routine dental care, but these services were not provided to the resident as required.