|§483.55 Dental Services |
The facility must assist residents in obtaining routine and 24-hour emergency dental care.
§483.55(b) Nursing Facilities.
§483.55(b)(1) Must provide or obtain from an outside resource, in accordance with §483.70(g) of this part, the following dental services to meet the needs of each resident:
(i) Routine dental services (to the extent covered under the State plan); and
(ii) Emergency dental services;
§483.55(b)(2) Must, if necessary or if requested, assist the resident-
(i) In making appointments; and
(ii) By arranging for transportation to and from the dental services locations;
§483.55(b)(3) Must promptly, within 3 days, refer residents with lost or damaged dentures for dental services. If a referral does not occur within 3 days, the facility must provide documentation of what they did to ensure the resident could still eat and drink adequately while awaiting dental services and the extenuating circumstances that led to the delay;
§483.55(b)(4) Must have a policy identifying those circumstances when the loss or damage of dentures is the facility's responsibility and may not charge a resident for the loss or damage of dentures determined in accordance with facility policy to be the facility's responsibility; and
§483.55(b)(5) Must assist residents who are eligible and wish to participate to apply for reimbursement of dental services as an incurred medical expense under the State plan.
Based on review of facility policies, clinical records and staff interviews, it was determined that the facility failed to obtain the required dental services for one of two residents (Resident R1).
A review of the facility policy "Dental Services" dated 12/18/18, indicated that residents with lost or damaged dentures will be promptly referred to a dentist, unless otherwise directed by the resident and/or responsible party.
A review of the clinical record progress notes dated 2/27/19, indicated "waiting for dental service to begin so the resident can be evaluated for replacement dentures."
A review of the clinical record on 5/9/19, did not include documentation that Resident R1 had been seen by a dentist as of that date.
During an interview on 5/9/19, at 10:35 a.m. p.m. Social Services Employee E1 confirmed that Resident R1's dentures were missing and the resident had not been evaluated for replacement dentures.
28 Pa. Code: 211.15(a) Dental services.
| ||Plan of Correction - To be completed: 06/07/2019|
1. Facility cannot retroactively obtain the required dental services for Resident R1, however Resident R1 has been assessed and there were no negative outcomes related to the lack of a dental consult. Resident R1 will be seen by the dentist by June 20, 2019 for replacement denture evaluation.
2. NHA, or designee, will educate the nursing and social services staff on the importance of timely follow up with dental issues.
3. DON, or designee, will audit the 24 hour report daily looking for reported dental concerns The DON/designee will review the 24 hour report 5x a week x 2weeks the weekly x2 weeks, then monthly x 2 weeks
4. The DON, or designee, will report audit results to the monthly Quality Assurance and Process Improvement Committee for review and frequency of audits.