Failure to Provide Timely Dental Extractions Due to Missed Preparation and Transportation
Penalty
Summary
The deficiency involves the facility’s repeated failure to ensure transportation and appropriate nursing preparation for a resident’s needed dental extractions, resulting in prolonged delay of care. The resident had an MDS showing intact cognition and a care plan documenting poor dentition with obvious tooth decay, broken teeth, and goals to remain free from mouth pain, with instructions to observe for mouth pain and obtain dental consults as needed. A county health department dental consultation documented that the resident was to have multiple tooth extractions and that Eliquis was to be held for 24 hours before the procedure. Despite this, a scheduled dental appointment was rescheduled because nursing staff did not hold the resident’s medications as ordered, and the Regional Director later confirmed that this appointment should have been kept and that nurses should have been aware of the medication hold requirement. Further delays occurred due to administrative and transportation issues. Another dental appointment was rescheduled because the resident’s insurance was incorrectly believed to be canceled, although the Regional Business Office Manager later stated this was a mistake and that the resident had active Medicaid coverage at the time. Additional appointments were rescheduled when the facility could not provide transportation after a change in facility ownership and while the new operator was researching insurance and title for the facility van, and because the van driver/scheduler was unable to secure local public transportation. The van driver/scheduler reported that all appointments had been pushed out by weeks and that the resident’s dental work had been on hold for a couple of months. As a result, the resident, who had multiple black and brown broken teeth with only three upper and three lower chipped teeth remaining, experienced a delay of approximately ten months from the initial visit when extractions were determined to be needed.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.