Failure to Provide Timely Dental Services and Dietary Adjustments
Penalty
Summary
A deficiency was identified when a resident with a history of dementia, contracture, and hemiplegia was not provided timely dental services for an ill-fitting lower partial denture. The resident reported being unable to wear the denture due to poor fit and discomfort since receiving it, which affected his ability to chew certain foods such as chicken and hamburgers. Despite repeated documentation in dental visit notes over several months that the denture did not fit and the resident was not wearing it, no effective adjustment or replacement was made for an extended period of approximately ten months. The resident remained on a regular diet despite his inability to chew certain foods, and staff were aware of his difficulties. The registered dietitian was not directly informed of the resident's issues with the denture or eating, and only considered a diet change after being specifically asked. Dental records indicated ongoing problems with the denture, requests for adjustments, and pending x-rays, but there was no evidence of follow-up or resolution after the x-rays were completed. The unit manager confirmed that the resident should have been referred for further dental evaluation and dietary review much earlier. Facility policy required prompt referral for dental services within three days of lost or damaged dentures and documentation to ensure adequate nutrition if delays occurred. However, the resident's ongoing inability to use the denture and lack of timely intervention or dietary adjustment demonstrated a failure to meet these requirements. The deficiency was substantiated by interviews, record reviews, and direct observations of the resident's continued difficulty eating and lack of appropriate dental or dietary support.