Failure to Provide Routine Dental Services for a Cognitively Intact Resident
Penalty
Summary
The facility failed to provide or arrange routine dental services for a long-term care resident, resulting in a deficiency related to dental services and nursing services. The resident, who was admitted in March 2025, was a Medicaid recipient and was documented as cognitively intact on an MDS assessment dated December 10, 2025. Pennsylvania Medical Assistance Dental Coverage for Adults allows exams, x-rays, and cleanings every six months, yet the resident reported during an interview in January 2026 that he had not seen a dentist since admission and was experiencing tooth pain requiring an extraction. Review of the clinical record showed no documentation that the resident had seen a dentist or had any dental appointments scheduled from admission through January 2026, and there was no evidence of any refusal of dental care by the resident. In an interview, the Unit Manager confirmed that the resident had not seen a dentist or had a dental consult since admission and that there was no documented refusal of dental services. The Unit Manager stated that an appointment was only scheduled after the resident reported tooth pain, and that no routine dental exams or visits had been arranged prior to the onset of pain. These findings demonstrate that the facility did not offer or obtain routine dental services for this resident as required under 28 Pa. Code 211.12(c)(d)(3)(5) Nursing Services and 28 Pa. Code 211.15(a) Dental Services.
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