CMS SOM App. A, Tag A-1573

• §483.55 Dental services. The facility must assist residents in obtaining

routine and 24-hour emergency dental care.

(a) Skilled nursing facilities. A facility…

(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—

(i) In making appointments; and

(ii) 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.

(b) 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:

(i) Routine dental services (to the extent covered under the State

plan); and

(ii) 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)(7)

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

Survey Procedures §482.58(b)(7)

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

Special Provisions Applying to Psychiatric Hospitals