|§483.55 Dental services.|
The facility must assist residents in obtaining routine and 24-hour emergency dental care.
§483.55(a) Skilled Nursing Facilities
§483.55(a)(1) Must provide or obtain from an outside resource, in accordance with with §483.70(g) of this part, routine and emergency dental services to meet the needs of each resident;
§483.55(a)(2) May charge a Medicare resident an additional amount for routine and emergency dental services;
§483.55(a)(3) 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;
§483.55(a)(4) 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 location; and
§483.55(a)(5) 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.
Based on clinical record review and staff interview, it was determined that the facility failed to ensure that dental services were arranged timely for one of four sampled residents. (Resident CR1)
Clinical record review revealed that Resident CR1 was admitted to there facility on March 23, 2018, with diagnoses that included dementia and atrial fibrillation. The resident had a physician's order for dental services to be provided as needed. On October 14, 2018, a request was made for the resident to be seen by the dentist for a yearly screening. The dental treatment recommendation form was sent to the responsible party for approval . Documentation provided by the facility revealed that the request was not acknowledged until July 1, 2019.
In an interviw on January 6, 2020, at 10:45 a.m., the Director of of Nursing confirmed that there was a delay in obtaining the approval of the responsible party for the resident to receive dental services.
28 Pa. code 211.12(d)(5) Nursing services.
Previously cited 2/2/18, 12/20/19
| ||Plan of Correction - To be completed: 01/10/2020|
1. CR1 Received dental care in July of 2019
2. The facility recognizes the residents are to be provided with Dental Care while residing in facility. The admission department will obtain initial consent for dental services on admission with nursing department follow-up to ensure residents are seen regularly.
3. Unit Managers will review dental reports monthly to ensure residents received dental care as scheduled and complete audits monthly until compliance is achieved. A house wide audit was completed, and new admissions have been reviewed.
4. DON will review Audits monthly x3 then quarterly x3 with follow-up reporting in quarterly QAPI meeting to assure compliance.