Failure to Provide Required Dental Consultation
Penalty
Summary
The facility failed to provide a dental consultation for a resident who was observed to be missing upper and lower teeth and reported not having dentures or having seen a dentist. The resident, who had a diagnosis of dysphagia and was on a mechanical soft diet, had a physician's order for dental health services as needed and was documented as edentulous in the dental hygiene progress notes. Despite these documented needs and orders, there was no evidence in the resident's record that a dental consultation had been provided since the previous year. Interviews with the Social Service Director and the Director of Nursing confirmed that there was no documentation of a dental visit for the resident and acknowledged that the resident should have been seen by the dentist according to facility policy. The facility's policy indicated that routine and emergency dental services should be available in accordance with the resident's assessment and plan of care, and that social services should assist with appointments and transportation. The lack of dental services was identified through observation, record review, and staff interviews.