Health inspection·November 22, 2023

F 0791 Provide or obtain dental services for each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, resident interview, staff interview and record review, the facility failed to ensure a resident received dental services in a timely manner. This affected one (Resident #33) of one reviewed for dental services. The facility census was 50. Residents Affected - Few Findings include Review of the medical record for Resident #33 revealed an admission date of 01/15/23. Diagnoses included kidney disease, emphysema, bipolar disorder and muscle weakness. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #33 was cognitively intact with a BIMS of 15 and required limited assistance of one staff member and for mobility and transfers. Review of the baseline care plan dated 01/15/23 revealed Resident #33 was noted to have broken teeth with intervention to ensure lighting in resident room was appropriate. Review of the progress notes dated 02/22/23 revealed Resident #33 was seen by the 360 care dentist and was found to need all top teeth (quantity of eight) extracted. The dental group recommended resident to be seen by an oral surgeon. The resident and family was provided the information to review. Review of the progress note dated 03/01/23 revealed social services spoke with the resident and daughter regarding dental follow up and the resident and family were interested in her getting scheduled for the oral surgeon to have teeth extracted with the possibility of getting dentures. Social Services informed family of process in getting dentures with Medicaid insurance and timeline of taking potentially several months for authorization. Social Services agreed to call around for a local oral surgeon who would accept the resident's insurance and be able to provide her services and confirmed family and the resident were unable to pay privately for dental extractions. Review of the progress note dated 03/07/23 revealed multiple dental offices were contacted and did not accept the resident's insurance. 360 dental service was contacted requesting a list of oral surgeons that accept Medicaid. Review of the progress note dated 03/14/23 revealed 360 dental provider sent list of possible providers further outside of [NAME] and resident and family were agreeable to offices being contacted for possible services. Review of the progress note dated 03/16/23 revealed social services contacted the four locations Page 1 of 2 366452 366452 11/22/2023 Lakes of Sylvania, The 5351 Mitchaw Road Sylvania, OH 43560

F 0791 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few provided by 360 dental and they did not accept the resident's insurance. Social Services contacted the county health department (about an hour from facility) and learned they did accept the insurance but were booked out through June and not taking any new patients at that time. Offices in further away were contacted and stated they would not accept resident from so far away. The resident and daughter were updated. No additional documentation was done from 03/17/23 to 11/22/23 related to finding a follow-up related to the dental services and resident was not seen for services since this. Observation and interview on 11/20/23 at 2:32 P.M. with Resident #33 revealed the dentist informed her she needed to have teeth pulled several months ago but had not heard follow up related to having an appointment or a provider able to perform the service. She revealed staff had looked at options but was unsure if they were still trying to find assistance for her. Interview on 11/22/23 at 9:30 A.M. with Social Services #569 revealed she checked into the resources that she knew about and was unable to find any providers that would accept Medicaid for dental services/surgery. She revealed she found online a resource with a county health department but they were unable to accept the resident until after June. Social Services revealed she did not document any follow up since 03/2023 and revealed she did not contact the local counties to see what services they offered. She revealed she did not reach out to the hospitals to see if they had any services or knowledge of services. Interview on 11/22/23 at 9:45 A.M. with staff at Dental Clinic #700 revealed they accepted Medicaid and had an oral surgeon come weekly. Staff revealed they were currently not scheduling appointments for new patients but could see Resident #33 same-day for any urgent or acute needs such as pain. Staff revealed they were hoping to re-open appointments for new patients in January. Staff revealed they had an open enrollment system throughout the year and the facility would need to keep checking in to check the status, but revealed they have had openings off and on this past year. Interview on 11/22/23 at 9:55 A.M. with the Director of Nursing (DON) revealed the facility was completing no follow up or monitoring related Resident #33's dental concerns and needing teeth extracted. 366452 Page 2 of 2