Failure to Provide Timely Dental Services for Resident with Non-Restorable Teeth
Penalty
Summary
A deficiency occurred when the facility failed to ensure timely dental services were provided to a resident with multiple non-restorable teeth. The resident, who had a history of stroke with partial paralysis, dementia, and depression, was identified as having poor dentition and expressed ongoing concerns about dental pain and the desire for dental repairs. Despite repeated assessments by dental staff and clear documentation of the need for dental intervention, including referrals for full mouth rehabilitation and later for removal of all remaining teeth and denture fabrication, there were significant delays in arranging the necessary dental appointments. The clinical record and interviews revealed that although referral letters and recommendations were uploaded into the electronic medical record (EMR) and communicated to nursing staff, the process for scheduling outside dental appointments was not effectively followed. The receptionist responsible for making appointments did not recall receiving earlier referrals and only scheduled appointments after significant delays. Missed transportation and a lack of follow-up further contributed to the postponement of dental care. Nursing staff and the Director of Nursing Services were unaware of the earlier referrals and did not document barriers or reasons for the delays in the EMR, as required by facility policy. Observations confirmed the resident continued to experience dental pain, had visible tooth fragments, and required modified meals due to the condition of their teeth. The resident expressed dissatisfaction with the facility's assistance in obtaining timely dental care and was unclear about when the necessary dental procedures would occur. The facility's policy required documentation of delays and assistance with transportation, but these steps were not consistently implemented, resulting in a prolonged period without appropriate dental intervention for the resident.