The resident, identified as R701 in state inspection records, told investigators on September 16 that they had "two molars that need to be removed but the facility never followed through setting up an appointment."
The dental crisis began in March when R701 complained of tooth pain in their lower right side. A dentist examined R701 at bedside on March 5 and found severely decayed teeth requiring immediate surgical intervention. The dentist documented that teeth numbers 30 and 31 — the lower right first and second molars — would need surgical extractions with sedation due to R701's agitation.
The dentist's treatment notes were explicit: "Refer to oral surgeon for extraction #30, #31." The provider spoke directly to the floor nurse, prescribed an antibiotic called Clindamycin, and documented rewriting the orders that same day.
R701 lives with diabetes, morbid obesity, heart disease, a chronic inflammatory skin condition, and schizoaffective disorder with bipolar episodes that include bouts of hypomania, mania, and depression. The combination of severe dental decay and complex medical conditions made the surgical referral medically necessary.
The facility's own policy, dated April 2019, states that "referrals to dietician, speech therapist, physician, or dental provider shall be made as appropriate." The policy further promises that "the facility will, if necessary or requested, assist the resident with making dental appointments and arranging transportation to and from the dental services location."
The policy also requires that "all actions and information regarding dental services, including any delays related to obtaining dental services, will be documented in the resident's medical record."
None of this happened.
When state inspectors questioned the Director of Nursing on September 17 about why R701 was never referred to an oral surgeon as ordered, the administrator could not provide an answer. The Director of Nursing — the same nurse who had ordered the Clindamycin antibiotic back in March — recalled that R701 was sent to the hospital on March 6, one day after the dental examination.
The Director of Nursing "could not confirm nor deny why the orders were not followed through or documentation of not being sent upon his readmission to the facility on March 20, 2025."
R701 returned from the hospital on March 20. The oral surgery orders remained unfulfilled through the summer and into September, when the resident spoke directly to state investigators about the ongoing dental pain.
The inspection records contain no evidence that facility staff attempted to contact an oral surgeon, schedule an appointment, arrange transportation, or document any delays in obtaining the ordered care. The facility's medical records show no follow-up on the March 5 dental orders during R701's six-month wait.
State inspectors found that Optalis Health & Rehabilitation of Bloomfield Hill failed to provide or obtain dental services for residents, specifically failing to obtain the requested and ordered oral surgery services needed for R701's escalated dental care.
The violation occurred despite the facility's written policy promising to assist residents with dental appointments and transportation, and to document any delays in obtaining dental services. The inspection found no such documentation in R701's medical record.
The dentist had provided clear instructions, spoke directly to nursing staff, prescribed antibiotics for the infection, and documented the urgent need for surgical extractions with sedation. The facility's failure to act on these orders left R701 living with severely decayed molars and ongoing dental pain for six months.
When inspectors arrived in September to investigate complaints, R701 was still waiting for the oral surgery that had been ordered in March. The resident's direct statement to investigators — that the facility "never followed through setting up an appointment" — contradicted the facility's written promises to assist residents with dental care arrangements.
The case illustrates how administrative failures can trap vulnerable residents in cycles of preventable pain, particularly those with complex medical and psychiatric conditions who depend entirely on facility staff to coordinate their care.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Optalis Health & Rehabilitation of Bloomfield Hill from 2025-09-17 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Optalis Health & Rehabilitation of Bloomfield Hill
- Browse all MI nursing home inspections