Failure to Arrange Timely Hospital Referral for Dental Extractions
Penalty
Summary
The facility failed to assist a resident in obtaining timely dental care after receiving a letter from a local oral surgery clinic indicating that the resident required referral to a hospital for full mouth extractions. The resident, who had diagnoses including heart failure and chronic kidney disease, was identified as having oral/dental problems related to poor oral hygiene and likely cavities. The care plan specified that licensed nurses or a social worker were responsible for coordinating dental care and transportation as needed. Despite a referral to a local oral surgery clinic and subsequent consultation, the clinic determined that the procedure should be performed in a hospital setting. However, there was no documentation that a formal referral to the hospital was ever made. Record reviews and interviews revealed that the social services staff contacted Denti-Cal and learned that both Denti-Cal and the local oral surgery clinic, as well as the hospital, declined services. The social services director stated that it became the nurse's responsibility to find a location for the procedure, but no progress note or documentation was found to confirm that a hospital referral was completed. The administrator also confirmed the absence of documentation for a formal hospital referral. The facility's policy required social services to arrange necessary dental appointments and document any extenuating circumstances for delays, but this was not done in this case.