Failure to Provide and Follow Up on Dental Services for Two Residents
Penalty
Summary
The facility failed to provide assistance and follow-up for dental care services for two residents. One resident, who had quadriplegia, malnutrition, muscle weakness, and depression, was observed to have multiple missing lower teeth and remaining teeth that were deeply stained. This resident reported not having seen a dentist since admission, despite a provider's order for a dental consult and documentation of missing or broken teeth in both the progress note and initial nursing assessment. The initial MDS did not indicate obvious cavities or broken teeth, and staff interviews revealed that the process for scheduling dental appointments was not followed, as the resident had been re-approved for Medicaid and should have been seen for dental needs. Another resident, admitted with malnutrition, gastrointestinal hemorrhage, chronic pain, and dependence on artificial feeding, reported having upper dentures but needing lower dentures. The care plan did not address the missing lower teeth, and there was no evidence in the electronic health record of a dental consultation or plan for lower teeth. Staff interviews confirmed that routine dental appointments were scheduled by social services, and emergent needs should have been referred out, but this was not done for the resident.