St. Louis Today reported that troubled nursing home St. Sophia Health and Rehabilitation Center received notice in October that Medicare and Medicaid would not pay for any new residents through the government insurance programs starting Nov. 2. The 240-bed nursing home is owned and operated by Midwest Geriatric Management, or MGM Healthcare, which owns 22 facilities in three states.
The latest problems stem from a resident who pulled out a dialysis catheter and bled to death in September. The death marks the second in two years that federal investigators linked to negligence at the nursing home. An 88-year-old woman with Alzheimer’s disease was found dead in a bathtub at St. Sophia last year after being left unsupervised for eight hours.
An investigative report dated Sept. 28 by the U.S. Centers for Medicaid and Medicare Services details the events based on interviews with St. Sophia staff and an emergency responder:
The patient came to St. Sophia on Sept. 7 with diagnoses that included heart failure, dementia, one-sided paralysis and a seizure disorder. The patient had a catheter for vein access in an arm, a dialysis catheter in the groin area and a feeding tube. The patient was also taking blood thinners. On Sept. 8 and Sept. 9 nurses reported the resident continually pulled at the tubing and “requires constant watching.”
At 4:18 a.m. on Sept. 9, a nurse noted that the patient continued to pull at the tubing. The next entry at 6:50 a.m. says the nurse “was called to the room to find a significant amount of blood on the floor and bed” after the patient pulled out the stitches and catheter. At 6:55 a.m. the patient was unresponsive, according to the nurse’s notes.
Investigators discovered that the patient’s electronic medical record was changed two days later to add notes at 5:42 a.m. and 6:38 a.m. showing all tubing intact. A nursing aide told investigators the patient pulled the feeding tube out earlier the same night. The aide told two nurses “all night, about a thousand times, what the resident was doing” but was not instructed to stay with the patient, according to the inspection report.
An emergency medical technician who was called to the facility later told investigators some of the blood that pooled under the bed was coagulated on arrival. “The resident was not conscious. Staff were unable to say when the incident happened or when (the patient) was last seen. Their stories conflicted,” the EMT told investigators.
Police were also called to the facility Nov. 3 after receiving a report of sexual abuse. Health inspectors returned to St. Sophia on Nov. 20 and found that on two occasions a resident sexually assaulted another resident who is severely mentally impaired, according to staff interviews.