Nursing Home Dentistry In Texas: Straight From the Trenches. Sarah J. Dirks, DDS TXOC - State of the State Symposium November 10, 2017

Similar documents
1/7/2014. Regulatory Reminders for Dental Care in Senior Living Facilities. Table of Contents

DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Dental Status and Services Critical Element Pathway

Dental Assessments for Nursing Home Residents: North Dakota as a Best Practice

Looking for Horses not Zebras! Common Oral Disorders in the Frail Elderly

Cognitive Impairment and Oral Health

The Role of Oral Health in Successful Care Transitions: How AAAs Can Address Oral Health Issues to Improve Health Outcomes

dental implants for tooth replacement be a confident you

Married Single Widowed Legally Separated. Full Time Part-time Retired Not Employed Currently

Good Oral Health: The Path to Good Overall Health

Overview. Improving Oklahoma Nursing Home Resident Outcomes through Person-Centered Oral Care. Nursing home participant benefits

2015 New Hampshire Oral Health Forum Live at the Forum: Medical-Dental Integration at the Community Level

Tuolumne Me-Wuk. Dental Clinic Greenley Road, Suite D Sonora CA Phone: Fax: Dear Patient,

The Gary and Mary West Senior Dental Center: An Integrated Model of Dental, Health, and Wellness Care for Older Adults

MEDICAID REIMBURSEMENT

Oral Care - Guidelines for residents and carers

THE COMPLETE GUIDE TO COMPREHENSIVE DENTISTRY. (AKA Whole-Health Dentistry)

Our Teeth. Word List: find each word from the list below in the table above (just circle each word on the table and cross it off from your list)

Dementia and Oral Care

Today s Date: Date of Birth: Social Security #: MM/DD/YYYY. Name: Age: Last First MI (nickname) Address: Street & Apt # City State Zip Code

Dr Farayi Shakespeare Moyana /6/2017 Do my KIDS need dental braces?

Dental Health for Individuals with Disabilities Lesson 2: Importance of Taking Care of Your Mouth

MEDICAL HISTORY DO YOU HAVE OR HAVE YOU HAD ANY OF THE FOLLOWING PLEASE CHECK ALL THAT APPLY. Patients s Name Date Yes No Yes No

I n d i a n E l d e r C a r e g i v e r

Texas Administrative Code

Oral Health Matters from Head to Toe

Patient Name: D.O.B. Who may we thank for recommending us: Name of Dentist: Date of last visit:

STEPHEN C. SNITZER, D.D.S.,

DRUG-RELATED OSTEONECROSIS OF THE JAW

Delta Dental of Illinois Children s Oral Health Report

MODULE 15: ORAL HEALTH ACROSS THE LIFESPAN

When Do You Need a. General Dentist vs. a Specialist?

Course #:

Oral Health Across the Life Span. MMS Women s Health Conference. Hugh Silk, MD, MPH Professor Nov 6, Family Medicine and Community Health

When Do You Need a. General Dentist vs. a Specialist?

Cancellation & No-Show Appointment Policy

ALL-ON-4 DENTAL IMPLANTS AN ALTERNATIVE TO DENTURES. Pasha Hakimzadeh, DDS

Yes No If yes Yes No If yes Yes No If yes Yes No If yes Yes No If yes Yes No If yes. Yes No Yes No

The Health of a Population is the Sum Total of the Health of its Individuals

Dental care and treatment for patients with head and neck cancer. Department of Restorative Dentistry Information for patients

Denture Care. August 08

Oral Care Program at Black-Mtn. Neuro-Medical Treatment Center. Changing the Culture of Oral Care One Mouth at a Time

GERIATRIC DAY HOSPITAL

Improving Oral Health in Older Persons Initiative Michael Wheeler MSc BEd (Hons) Cert Ed RDH

Keeping Your Teeth in Mind. A guide for people experiencing psychosis and those who care for them

When You Need a. General Dentist Vs. a Specialist

Don t forget your toothbrush!

Best Practices in Oral Health for Older Adults -How to Keep My Bite in My Life!

Oral Health Baseline Data Collection Tools

Diabetes and Oral health: A 21 st Century issue to be addressed

Oral care & swallowing

The Implications for Poor Oral Health in the Elderly

MEDICAL HISTORY FULL NAME D.O.B. SEX

Here are some frequently asked questions about Endodontic treatment:

Yes, but I also have a sore tooth. I think I might have a cavity. Okay. We ll do an X-ray before your cleaning. Which tooth is bugging you?

Mouth Care for Adult Patients in Hospital. Fiona Corcoran: DF2 Community/Dental Public Health

INSTRUCTOR S GUIDE. Oral Health. First Edition, 2006

[ARKANSAS OLDER ADULT ORAL HEALTH SCREENING SURVEY]

Twohig Dentistry Dental and Oral Health Information

Dental Care for Homeless People

Your Smile: Braces By Blalock

We re Passionate About

Developed by: The Inter Tribal Council of Arizona, Inc. Dental Clinical and Prevention Support Center

Oral Health Care for Pregnant Women

PATIENT HEALTH HISTORY

Oregon Oral Health Surveillance System public health division Center for Prevention & Health Promotion Oral Health Program

Evidence-Based Integrated Care Plan (EBICP)

P.O. Box Abu Dhabi, Tel: Fax:

New Patient Information

Last Name: First Name: Address: City: State: Zip: Home #: Work #: Mobile #: Gender: SS#: DOB: Marital Status: Employer:

Dr. David J. Rudolph D.D.S., M.S., Ph.D. Practice Limited to Orthodontics F: Patient Rights

Oral Health: An Essential Component of Primary Care. Executive Summary

Medical and Dental Health History Form Getting to Know You As Our Patient

ORAL HEALTH AND HYGIENE. Erica R. Thomas, MS DDA Health Initiative

Recommendations for non-dental health professionals

MEDICAL HISTORY. List all medications, supplements, and or vitamins taken within the last two years. Drug Purpose Drug Purpose

PATIENT INFORMATION DATE PATIENT INFORMATION INSURANCE INFORMATION PERSON TO CONTACT IN CASE OF EMERGENCY. r: No METHOD OF PAYMENT AUTHORIZATION

Dental Implants. Tel: Web:

Mouth care for people with dementia. Mouth care for people with dementia. Staying well with dementia

PATIENT INFORMATION. Whom may we thank for referring you to our office?

Emergency Contact Information: Name Address Phone Number. How did you hear about our office? Reason for your visit today?

PATIENT FORMS. Patient Information. Responsible Party. Referral Information. Name: Birth Date: Social Security #: Home Phone: Cell Phone:

New Patient Paperwork

Are Dental Implants Right for You

Dental and Oral Benefit

Kingsland Family Dental Registration and Medical History

Diabetes and Dental Health

Oral Health Screening

Rebecca King, DDS, MPH NC State Dental Director Section Chief, Oral Health Section

Personal Information Protection Act Consent Form

Your Own Teeth and Gums

Evidence Based Practice Information Sheets for Health Professionals. This Information Sheet Covers the Following: Oral Diseases.

Winnipeg Regional Health Authority / Oral Health Program

SLEEP SCREENING QUESTIONNAIRE

CAREER INFORMATION WHO IS THE REGISTERED DENTAL HYGIENIST?

Last: First: MI: Nickname:

Welcome To Our Office

Dental Implants. Are they an option for you? SAMPLE

Mouth care. Symptoms and complications. Myeloma Infosheet Series. Infoline:

AgePage. Taking Care of Your Teeth and Mouth. Tooth Decay (Cavities) Gum Diseases

Dental Health E-presentation.

Transcription:

Nursing Home Dentistry In Texas: Straight From the Trenches Sarah J. Dirks, DDS TXOC - State of the State Symposium November 10, 2017

Topics: Long Term Care Population Emergency Dental since March 2015 Federal Regulations versus State Regulations Positive Momentum in Texas

Topics: Long Term Care Population March 2015 State managed Medicaid care changed to MCO Medicaid managed care MCO = Managed Care Organizations Long-term care facilities were carved into managed care

Emergency Dental Care in Nursing Homes in Texas Pre March 2015 State managed emergency dental for residents. Emergency fees are same as in 1999. Example: $60 routine extraction Payment for emergency dental care was elusive and pragmatically nonexistent.

Topics: Long Term Care Population Emergency Dental since March 2015 Federal Regulations versus State Regulations Positive Momentum: CMS Quality Momentum + Texas as a Leader Messaging: Medically Necessary Oral Care

Regulatory Big Picture Federal Regulations Texas Regulations Very basic/set up as a minimum for states to use. Nursing home staff are generally unaware of Federal Regulation specific to dentistry. Surveyors, if looking for dental violations, are typically looking at federal regulation violations only. Minimum Data Set = MDS More proactive and comprehensive. Nursing homes are not aware of Texas specific regulations. Surveyors are not looking at Texas specific regulations. If current Texas regulations were followed, oral health in Texas nursing homes would be revolutionized. Section L: Oral/Dental Status

Minimum Data Set: 3 rd Quarter - 2017 Section L: Oral/Dental Status of Residents Broken or loosely fitting full or partial denture No natural teeth or tooth fragments Abnormal mouth tissue Obvious or likely cavity or broken natural teeth Inflamed gums, bleeding gums, loose natural teeth Mouth or facial pain or discomfort with chewing None of the above

Question: 3 rd Quarter Data - 2017 Texas Data: What % of residents do you think have inflamed gums, bleeding gums, loose natural teeth? (a) 85.17% (d) 55.17% (b) 75.17% (e) 25.17% (c) 65.17% (f) Less than 1% 8

Minimum Data Set: 3 rd Quarter 2017 Broken or loosely fitting full or partial denture No natural teeth or tooth fragments Abnormal mouth tissue Obvious or likely cavity or broken natural teeth Inflamed gums, bleeding gums, loose natural teeth Mouth or facial pain or discomfort with chewing None of the above

3 rd Quarter Data - 2017 National Data for none of the above : Ranges from 56.27% to 80.74% Average of all States = 67.97% Texas Data? What % of residents do you think have none of the above? (a) 80.74% (d) 50.48% (b) 70.48% (e) 20.74% (c) 60.74% (f) Less than 1% 10

Topics: Emergency Dental since March 2015 Federal Regulations versus State Regulations Positive Momentum: CMS Quality Momentum + Texas as a Leader Messaging: Medically Necessary Oral Care

CMS, Texas, and Quality Momentum Recognize, communicate, and enforce Texas specific regulations. Communicate the need for accurate minimum data set collection. Prior to making a referral for admittance to a particular nursing facility. will there be more scrutiny of: 12

Quality Momentum & Referrals Prior to making a referral for admittance to a particular nursing facility. will there be more scrutiny of: Hospital readmissions data? Preventable infections data? Aspiration pneumonia data, etc.? Compliance with dental regulations in Texas? Oral health of residents? 13

Topics: Emergency Dental since March 2015 Federal Regulations versus State Regulations Positive Momentum: CMS Quality Momentum + Texas as a Leader Messaging: Medically Necessary Oral Care

Interdisciplinary Approach = Goal Focused Dentists fix teeth RDH s clean teeth Dental Team & Medically Necessary Goals Fix a broken tooth. Fill a cavity. Medical Director, Primary Care Provider, Director of Nursing, Speech Pathologist, Nutritionist, Hospice Nurse, Geriatric Psychiatrist, Social Worker, Case Manager, Geriatrician. Toothache. Clean teeth. Refit dentures. Replace dentures. Teach patient how to floss. Etc. Improve oral health to lower potential hospital readmissions due to poor oral health/dental infection, fever of unknown origin, etc., unexplained delirium/ agitation, improve A1c, lower aspiration risk, pain relief, reduce pneumonia, reduce the risk of bacterial endocarditis, unexplained weight loss, infection, cancer screening, septicemia, bisphosphonate osteonecrosis, oral neglect, tissue infection, oral wound care, reduce risk of choking due to dysphagia, rehabilitation of speech post stroke, improve PO nutrition, assist with diet upgrade, evaluate potential dental cause of unexplained weight loss, needed for comfort care, low self esteem contributing to depression, unexplained agitation, improve quality of life, return to masticatory function, relief of chronic oral suffering.

New Patient Referral in 2017 Admitted to nursing facility in 2011 Abnormal weight loss/malaise Rheumatic heart disease multiple valves involved Multiple hospitalizations 18

Thank you! dirks.dds@hotmail.com 210-617-4446

2024 © healthdocbox.com Privacy Policy | Terms of Service | Feedback