Failure to Provide Dental Services for Resident with Oral Health Needs
Penalty
Summary
The facility failed to provide or obtain necessary dental services for a resident with significant oral health needs. The resident, a 69-year-old woman with diagnoses including Parkinson's disease, protein-calorie malnutrition, and rhabdomyolysis, had no natural teeth and experienced pain when eating certain foods. Despite a care plan identifying her risk for oral health problems and a physician order for a dental consult as needed, there was no evidence that a dental consult was arranged or that the resident was seen by a dentist during her stay. Record reviews showed that the resident's quarterly MDS assessment did not reflect mouth or facial pain, but the resident herself reported difficulty chewing and pain with hard foods during an interview. She stated she had not seen a dentist in three years, including the duration of her stay at the facility. Staff interviews revealed a lack of clarity and follow-through regarding the process for dental referrals, with social services, nursing, and administration each describing different responsibilities for ensuring dental care was provided. The resident was not added to the list for the mobile dental service, and there was no documentation of a dental exam or consult in her records. The facility's policy required that oral health services be available and that social services assist with dental appointments and transportation, following notification from nursing. However, the breakdown in communication and lack of action resulted in the resident not receiving the dental care outlined in her care plan and physician orders. This failure was identified through observation, interviews, and record review, and directly affected the resident's ability to eat comfortably and maintain oral health.