Failure to Provide Timely Dental Services for Resident with Ongoing Dental Pain
Penalty
Summary
A deficiency occurred when the facility failed to offer and provide necessary dental services to a resident with a history of dysarthria following cerebral infarction, anxiety disorder, chronic pain, major depressive disorder, and alcohol abuse. The resident had a moderate cognitive impairment and had been prescribed Oragel for oral pain, but the medication was never administered. Despite a dental referral recommending evaluation and extraction of specific teeth, there was no evidence in the medical record or care plan of follow-up or interventions for dental pain, and the resident's complaints were not documented in progress notes. The resident reported experiencing a toothache for an extended period, indicating that the pain was present on average three days a week and that some teeth needed to be pulled. The resident stated that he routinely requested Tylenol for the pain and was told by staff that he could not see a dentist due to insurance coverage issues. Staff interviews revealed inconsistent awareness of the resident's dental pain, with some staff recalling complaints and others not, and there was confusion regarding the process for dental referrals and follow-up. Although the facility's dental policy required routine and emergency dental care to be available, including for acute dental pain, the resident did not receive timely dental services or appropriate follow-up after the initial referral. The lack of documentation, follow-up, and provision of dental care led to the deficiency identified during the survey.