Failure to Provide Timely Pain Management After Dental Procedure
Penalty
Summary
Facility staff failed to provide safe and appropriate pain management for a resident following a dental procedure. The resident, who had diagnoses including Parkinson's disease, heart failure, and dementia with depression and anxiety, was assessed as having moderately impaired cognitive abilities. The care plan identified a toothache and included interventions such as a dental appointment and administration of medications as ordered. After the dental procedure, there was no documentation in the clinical record regarding the services received or any assessment by facility staff of the resident's status post-procedure. During an interview, the resident exhibited facial edema, grimacing, and reported ongoing pain and bleeding from the mouth, stating that pain medication had not been provided. An LPN confirmed that although pain medication was available, it had not been administered since the dental procedure, citing the resident's refusal of medications earlier in the day. However, when asked again, the resident accepted and received pain medication. Despite this, the resident continued to report pain later in the day. Facility leadership did not provide comments or express concerns regarding these findings.