Missouri nursing home loses Medicare funds after patient bled to death in September

Florissant, Mo.-based St. Sophia Health and Rehabilitation Center has lost its Medicare and Medicaid funding after CMS investigators linked a recent patient death to quality deficiencies observed at the facility during an inspection on Sept. 28, according to an Oct. 13 letter from CMS addressed to Lisa Anderson, the facility's administrator.

Here are five things to know.

1. CMS' investigation into St. Sophia occurred after a resident of the facility pulled out a dialysis catheter and bled to death in September. The incident marks the second patient death in two years at the facility linked to negligence by federal investigators. In 2016, an 88-year-old resident with Alzheimer's was found dead in a bathtub after being left unattended for eight hours, according to a report from the Louis Post-Dispatch.

2. The most recent death occurred in a patient admitted to the 240-bed nursing home on Sept. 7 with diagnoses of heart failure, dementia and a seizure disorder, among other morbidities. The patient was on blood thinners and had a catheter in the arm, a dialysis catheter in the groin area and a feeding tube.

3. At 4:18 a.m. on Sept. 9, a nurse documented that the patient was pulling at the tubing. The next entry, made at 6:50 a.m., said the nurse was called to the room and found a significant amount of blood on the floor as a result of the patient pulling out stitches and the dialysis catheter. At 6:55 a.m., the patient was unresponsive.

4. CMS investigators discovered two additional notes — one at 5:42 a.m. and one at 6:38 a.m. — were added to the electronic medical record two days after the incident. The added notes described the patient's tubing as remaining intact at those times. However, an emergency medical technician who responded to the incident said some of the blood pooled under the bed was coagulated upon arrival.

"Staff were unable to say when the incident happened or when [the patient] was last seen. Their stories conflicted," the EMT told investigators, according to the St. Louis Post-Dispatch.

5. As a result of the investigation, St. Sophia will not be reimbursed for new Medicaid or Medicare residents before March 28, 2018, or until conditions improve.

In a statement to the St. Louis Post-Dispatch, Creve Coeur, Mo.-based Midwest Geriatric Management, which runs the Florissant nursing home, said, "The safety, comfort and well-being of each individual resident is the sole focus of the professional and compassionate staff at St. Sophia. Out of respect for the privacy rights of all of our residents, and in compliance with federal and state law, we cannot comment further about any specific care provided or resident admissions."

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