Failure to Provide Required Dental Services and Assess Oral Health Needs
Penalty
Summary
The deficiency involves the facility’s failure to provide access to routine and emergency dental services for a resident in accordance with its own Dental Services Policy and the resident’s physician orders and care plan. The facility’s policy from 2018 states that routine and 24-hour emergency dental services are available through a contracted dentist who comes to the facility monthly. The resident was admitted with multiple diagnoses, including Parkinson’s disease, dysphagia, GERD without esophagitis, and unspecified protein-calorie malnutrition. Physician orders dated 05/19/23 directed that the resident receive dental evaluation and treatment as indicated, and the care plan dated 11/27/24 documented that the resident was dependent on assistance with oral hygiene. Multiple MDS assessments documented that the resident required supervision or touching assistance for oral hygiene. Despite these orders and assessments, review of the electronic health record as of 02/04/26 showed no documentation that the resident had ever received a dental evaluation or treatment since admission. A progress note dated 12/29/25 listed multiple oral health areas, including dentures, mouth tissue, natural teeth, cavities, gums, and pain or difficulty chewing, all marked as “Not Assessed.” On observation, the resident was noted to have broken teeth with visible plaque buildup and discoloration, and in interview the resident reported not having seen a dentist since before admission and experiencing dental pain that staff were aware of. The DON confirmed in interview that the resident had not received dental services since admission due to the facility’s inability to secure mobile dental services and the resident being bedbound and unable to transfer to a wheelchair for outside appointments, and acknowledged that the resident should have had a dental evaluation and/or treatment but did not.
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