Failure to Provide Timely Dental Services and Follow-Up for Missing Dentures
Penalty
Summary
The facility failed to ensure timely follow-up and provision of dental services for residents with missing dentures, affecting two of three residents reviewed for dental concerns. For one resident with a history of stroke, dementia, and malnutrition, the facility became aware of missing bottom dentures in August but did not initiate contact with a dental provider until October. The resident was placed on a mechanical soft diet due to the loss, which she disliked, and there were multiple delays and cancellations in scheduling dental appointments, including issues with payment authorization and communication with the dental office. The process to obtain replacement dentures was prolonged, with documentation showing significant gaps between identification of the issue and follow-up actions. Another resident with hemiplegia, diabetes, and vascular dementia also experienced a lack of timely follow-up after reporting missing dentures. Although prior authorization for denture adjustments was submitted, there was no documented follow-up or evidence that the resident received any denture adjustments for several months. The resident reported the dentures as stolen and expressed dissatisfaction with the modified diet. Staff interviews revealed a lack of awareness and inconsistent reporting regarding the missing dentures, and attempts to identify found dentures were unsuccessful due to missing identification labels. Facility policy required prompt investigation and follow-up within three days for lost or damaged dentures, as well as proper documentation and referral. However, the facility did not adhere to these requirements, resulting in extended periods without dentures for the affected residents and delays in dental care coordination. The deficiency was substantiated through observations, record reviews, and staff and resident interviews.