Failure to follow up on recommended dental services for a resident with impaired cognition and assistance needs for oral hygiene. Dental notes documented heavy tartar and recommendations for cleaning, scaling, root planing, and x-rays, while the resident reported something stuck in his teeth and staff were told about the concern. SSD stated the family agreed to pay out-of-pocket for cleaning, the resident had no dental insurance, and the SSD did not follow up on the dental service; QA stated the resident was at risk for pain and reduced food intake leading to weight loss.
Failure to ensure timely dental follow-up for a resident with painful teeth. The resident had multiple bottom front teeth visible at the gumline and reported tooth pain; he had been seen by a dentist and was supposed to have extractions, but the treatment had not occurred months later. SS stated the resident wanted extractions only, and the facility did not have a process for ensuring needed dental treatment was completed.
Failure to provide timely dental services for a resident with DM2, a below-the-knee amputation, and HTN. The cognitively intact resident requested dental hygiene and evaluation of a broken tooth causing discomfort, but the request was not followed up. The DON said dental visits occurred periodically and referrals were made for concerns, while the SSD confirmed the resident had been in the facility for two months without a baseline dental exam and that a prior dental visit did not include the resident due to insurance coverage issues.
A resident with decision-making capacity reported tooth pain and was seen by the facility dentist, who documented possible retreatment and/or a new crown and noted that an outside dental appointment would be arranged to save the tooth. The resident later stated she still wanted to see her primary dentist for a second opinion and had been waiting months for an appointment, while the SSD confirmed the follow-up dental visit had not been scheduled.
Failure to Arrange Dental Consultation and Treatment: A resident with DM2, anemia, dysphagia, and major depressive disorder had missing and broken teeth, no dentures, and no recent dental visit despite wanting treatment completed and reporting the need for a dental consult. Records showed dental consultation was listed as needed, the care plan identified dental problems, and staff, including the SSD, DPC, and DON, acknowledged the resident was not provided dental services.
A resident with full dentures and a BIMS of 15 was found without a lower denture, and only one denture was seen in a cup. The resident stated the lower denture was broken or missing and reported trouble chewing at times, while a CNA said the missing denture had been noticed and reported to the charge nurse about two weeks earlier. A nurse later stated no report of the missing denture had been received, and the resident ate lunch without dentures.
A resident with intact cognition and a need for setup or clean-up assistance with eating requested teeth and was seen by the dentist, who recommended tooth extractions and new dentures/partials. The SSA later acknowledged there was no follow-up after the dental visit and that she overlooked the resident’s dental needs. The DSD and DON stated social services was responsible for dental scheduling and that the lack of timely follow-up delayed denture fitting.
Failure to follow up on dental treatment after extractions. A resident with RA, enterocolitis, swallowing/nutritional concerns, and moderate cognitive impairment was observed without dentures and stated she wanted them. The dentist recommended full extractions with immediate full dentures, but after extractions were completed, the record showed no documented follow-up with the dental provider regarding denture impressions or denture status. The RDH later noted the resident was missing too many teeth to chew and break down food properly, and the SSM stated she did not follow up after the dental visit.
Failure to Follow Up on Denture Needs: A resident with loose-fitting and missing dentures was unable to chew effectively, and the SSD did not follow up with the dental office regarding the resident’s denture needs. The resident reported being without dentures for over a month, feeling abandoned, and wanting to chew food but being unable to do so. Dental notes showed routine follow-up recommendations only, while the facility record also reflected a dental consult order for denture evaluation and the facility policy required referral for damaged or lost dentures within 7 days.
The facility failed to provide timely dental follow-up for two residents whose dental notes documented a need for extractions. One resident with a hx of stroke and left-sided weakness had a loose, blackened tooth and reported pain, while another resident with memory loss and muscle weakness had broken, jagged teeth with dark areas along the gumline and wanted to see a dentist. The SSD confirmed there had been no follow-up to schedule the recommended dental care, and later dental notes described decayed teeth and antibiotic treatment for likely infection.
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