F0580

D

Failure to Notify Provider and Follow Up on Significant Dental Findings

Manchester, Connecticut Survey Completed on 03-25-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to notify the resident’s provider and nursing staff of significant dental findings and to follow up on recommended dental care. A resident with dementia, Parkinson’s disease, stage 3 chronic kidney disease, hypothyroidism, protein-calorie malnutrition, type 2 diabetes mellitus, and three unhealed stage 4 pressure ulcers was care planned for oral/dental health problems, including poor oral hygiene and the need to monitor and report signs and symptoms of oral/dental issues. A dental visit on 9/25/25 documented that the resident had cavities on every tooth, devastated dentition likely infected or a great source of bacteria, and that the resident would be healthier without the remaining teeth. The dentist recommended an FMX to determine the best referral for further intervention and dental cleanings every three months due to poor oral health. However, from 9/25/25 through 3/25/26, the clinical record contained no progress notes about this dental visit, the need for x‑rays, the condition of the dentition, or any notification to the provider about these issues.

Subsequent dental hygienist schedules showed that the resident was not treated on multiple dates over approximately six months, with reasons including not being on the hygienist’s list and the resident being at the hospital, and there was no evidence that these missed visits were communicated to nursing or the provider. The Director of Social Services, who managed outside providers, acknowledged seeing the 9/25/25 dental note but did not ensure nursing was aware of the findings or arrange additional follow-up, and confirmed the resident was repeatedly on the list but not seen. The DON stated she was unaware of the 9/25/25 dental visit and the missed hygienist visits, despite schedules being addressed to her, and indicated that the Director of Social Services should have notified nursing and a provider of the missed visits. The APRN reported she was unaware of the dental findings and would have evaluated and treated the resident if notified, and that alternative arrangements should have been made after missed appointments due to hospitalization. The facility’s Notification of Changes policy required informing and consulting with the provider and notifying the resident or representative when there is a significant change requiring alteration of treatment, but there was no policy available for outside consults and follow-up.