A resident with Parkinson’s disease and PVD had a fractured tooth that was evaluated by a mobile dental provider and the in-house dentist, who recommended extraction and prescribed antibiotics and pain medication. After physician approval and family consent, the extraction still was not completed because local oral surgeons would not accept Medicaid, the family was told to pay privately or change plans, and the record did not show coordination with a distant dental office or clear communication about transportation. The resident and family said transportation was never offered, and the resident remained without the recommended extraction for 8 months before death.
A resident with CKD and PVD, who was cognitively intact, had multiple non-restorable teeth and retained root tips with a plan for extractions so dentures could be made. Although medical clearance was obtained and staff noted the procedure would be scheduled, the record showed no completed extractions, no documentation explaining the delay, and no evidence the procedure had been scheduled during the survey period. The resident reported intermittent tooth pain for months while waiting for the dental work.
A resident with Parkinson’s disease and significant muscle weakness did not receive timely dental services after dentures went missing. The resident was observed with no teeth or dentures, the spouse reported the new dentures had disappeared, and staff acknowledged the need for replacement but said the resident was not yet eligible.
Failure to Provide Timely Dental Services: A resident with dysphagia and HTN, who was cognitively intact and on Medicaid, had dental impressions taken for complete upper and lower dentures but then had no further documented follow-up with the dentist. The resident reported waiting a long time for dentures, had not received updates, and had not seen the dentist recently; the record showed no further communication after the initial dental consult and impressions.
A resident with type 2 DM and CHF reported not having dentures and said they had requested dentures several times. The clinical record showed no evidence that the facility arranged or followed up on dental services for a dental assessment or dentures, and the DSS confirmed there was no documentation of any further dental consults.
Failure to provide routine dental services for two residents was identified. One resident had several missing and broken teeth, a partial that no longer fit, and was being served cut-up food, while the other resident reported not seeing a dentist since admission and having multiple cavities. Both residents had care plans noting potential oral/dental issues, but there was no evidence the facility offered or assisted with dental care, and the DON and NHA confirmed the findings.
Failure to provide routine dental care and obtain needed dental clearances delayed treatment for two residents. One resident with encephalopathy had no documented routine dental evals and, after reporting a broken partial bridge and sharp pain, no dental appt or treatment was arranged by survey exit. Another resident with dementia and severe cognitive impairment had a broken molar with infection; although the dentist prescribed antibiotics and the physician clearance was completed, the record did not show the required consent forms were completed so the recommended extraction could proceed.
A resident with hydrocephalus and weakness reported mouth pain for months, but dental care was delayed despite repeated complaints to staff. The dentist initially evaluated the resident and planned extractions, but the procedure was postponed because consent was not obtained in time, and the resident was not scheduled for the next dental visit. The facility’s policy required assistance with routine and emergency ancillary services, including urgent dental treatment for pain.
Failure to provide routine dental services for two residents was identified. One resident had broken or likely cavity-affected natural teeth, a dental care plan, and limited dental documentation, but no evidence of twice-yearly professional dental services under the State plan. Another resident was edentulous, reported not being offered a dentist since admission, had ill-fitting dentures at home, and the facility could not produce documentation that dental services were offered despite a care plan noting dental consultation as needed.
Failure to provide ordered dentures to a resident. The resident reported being fitted for full upper and lower dentures but never receiving them, and said staff did not follow up. Dental consults documented the resident’s request for dentures and later recommended full upper and lower dentures, while the NHA confirmed the dentures were made but not released because of a payment dispute.
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