Failure to Provide Timely Dental Care Following Tooth Injury
Penalty
Summary
The facility failed to provide routine and 24-hour emergency dental care for a resident who experienced a chipped front tooth while at the facility. The resident, who was cognitively intact but dependent for transfers, dressing, and wheelchair locomotion, had multiple diagnoses including diabetes, hemiplegia, stroke, seizures, and malnutrition. The resident's oral/dental status was left blank on the Minimum Data Set, and there was no documentation regarding oral care in the care plan. After the tooth broke, the resident reported pain and difficulty eating, and repeatedly communicated these issues to staff, but did not receive timely dental care. The resident's dental needs were not addressed promptly. Although a dental appointment was scheduled, the resident was unable to be seen due to an inability to transfer to the dental chair. No alternative arrangements were made, and the resident continued to experience pain and embarrassment about the appearance of the tooth. Staff interviews revealed a lack of follow-up and communication regarding the resident's ongoing dental issues, with the social worker and nursing staff each assuming the other was responsible for arranging care. The resident and family made several requests for dental care, but these were not acted upon in a timely manner. The resident eventually developed a dental abscess, for which a physician prescribed antibiotics. However, there was no evidence of further dental intervention or resolution of the underlying dental problem. Staff were unaware of the resident's ongoing pain and the need for dental care, and there was no documentation of follow-up or reassessment after the initial failed dental appointment. The lack of coordination and follow-through resulted in the resident waiting over a year without appropriate dental care.