Health inspection·August 5, 2024

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 medical record review, resident and staff interview, and review of a facility policy, the facility failed to timely refer a resident for dental services when dentures went missing. This affected one (#51) of 16 residents identified by the facility who wore dentures. The census was 82. Residents Affected - Few Findings include: Review of Resident #51's medical record revealed the resident was admitted on [DATE]. Diagnoses include morbid (severe) obesity due to excess calories, Alzheimer's disease, and gastro-esophageal reflux disease without esophagitis. Review of the annual Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #51 was severely impaired cognitively and was assessed with no natural teeth or tooth fragments and was edentulous. Review of a nursing progress note dated 07/21/24 revealed Resident #51 indicated her teeth (dentures) were missing. The resident stated she had them in a plastic cup in her chair last night. The room was searched by several staff and family, and the teeth were not found. A laundry aide verified no teeth were found in any clothing or linen. Interview on 08/01/24 at 8:07 A.M. with the Director of Nursing (DON) revealed she was not aware of any dentures missing for Resident #51. Interview on 08/01/24 at 9:01 A.M. with Resident #51 verified she was missing her dentures. Resident #51 stated the facility looked, but did not find them and no emergency dental care was set up for her. Interview on 08/01/24 at 8:56 A.M. with the Assistant Director of Nursing (ADON) revealed she heard about Resident #51's missing dentures and stated the social worker would handle the issue. Interview on 08/05/24 at 8:15 A.M. with the Director of Social Services (DSS) revealed 08/01/24 was the first she was made aware about Resident #51's missing dentures. DSS stated she would begin the process of getting Resident #51 referred to dental services. Interview on 08/05/24 at 1:30 P.M. with the Administrator and ADON revealed they looked in Resident #51's room again for the missing dentures and did not find them. Interview with the Administrator on 08/05/24 at 11:30 A.M. revealed she did not know Resident #51's Page 1 of 2 366487 366487 08/05/2024 Tallmadge Health & Rehab Center 619 Northwest Avenue Tallmadge, OH 44278

F 0791 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few dentures were missing and dental services were in the morning of 08/05/24 to begin the replacement process for the missing dentures. Review of the facility policy titled, Dental Services Policy, dated 04/02/24, revealed the facility will promptly, within three days, refer residents with lost or damaged dentures for dental services. The Director of Nursing Services, or his/her designee, or any clinical staff member is responsible for notifying Social Services of a resident's need for dental services. This deficiency represents non-compliance investigated under Master Complaint Number OH00156123. 366487 Page 2 of 2