Failure to Provide Follow-Up Dental Services and Dentures
Penalty
Summary
The facility failed to provide follow-up dental services and obtain dentures for one resident who had previously undergone multiple tooth extractions. The resident, who was cognitively intact and had a history of Alzheimer's Disease, diabetes, heart failure, and muscle weakness, reported that after having teeth extracted months prior, they had been waiting to be measured for dentures and had not been informed by staff about the process. Review of the medical record showed a signed consent for dental treatment, a physician's order for dental consults as needed, and documentation of the extractions and a follow-up dental visit. The dental note from the follow-up visit recommended another four weeks of healing before starting denture impressions, with a next visit planned for the first step in denture fitting if approved. However, there was no evidence in the medical record that the denture impressions were completed or that the facility contacted the dental service to ensure this occurred. Interviews with facility staff revealed that the resident had not been seen by the dentist since the extractions, and the process for obtaining dentures was missed. The Director of Nursing and Unit Manager both indicated that the responsibility for scheduling dental appointments and following up on recommendations was shared between the Medical Record Director and nursing staff, but the recommendation for dentures was not acted upon, resulting in the resident not receiving necessary dental follow-up.