Guideline text:
(Rev. 183, Issued: 10-12-18, Effective: 10-12-18, Implementation: 10-12-18)

## §482.58(b)(8) Dental services (§483.55)

- §483.55   Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care.
- (c) Skilled nursing facilities. A facility

(1) Must provide or obtain from an outside resource, in accordance with §483.70(g), routine and emergency dental services to meet the needs of each resident;

(2) May charge a Medicare resident an additional amount for routine and emergency dental services;

(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;

(4) Must if necessary or if requested, assist the resident-

(iii)In making appointments; and

(iv) By arranging for transportation to and from the dental services location; and

(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.

(d) Nursing facilities. The facility-

(1) Must provide or obtain from an outside resource, in accordance with §483.70(g), the following dental services to meet the needs of each resident:

(iii)Routine dental services (to the extent covered under the State plan); and

(iv) Emergency dental services;

(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;

(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;
- (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
- (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.

## Interpretive Guidelines §482.58(b)(8)

Refer to Appendix PP of the State Operations Manual (SOM) for interpretive guidelines.

## Survey Procedures §482.58(b)(8)

Refer to Appendix PP of the State Operations Manual (SOM) for survey procedures.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"anchor": "lost or damaged dentures identified", "delay_exception_documentation_required": true, "max_delay_minutes": 4320, "target": "referral for dental services"}, "rule_type": "temporal", "scope_tags": ["clinical", "facility", "legal"]}