FRENCHVILLE — According to documents the Division of Licensing and Regulatory Services of the Department of Health and Human Services provided to the Fiddlehead Focus, an investigation of St. Joseph Nursing & Rehabilitation Center in Frenchville on Nov. 19 and 20 found deficiencies in care that resulted in DHHS issuing a finding that conditions at the facility placed patients in “immediate jeopardy.”

The death of an elderly female resident of the 42-patient facility, which resulted from an accident at the residential care center on Nov. 14, prompted the investigation. The resident died at Northern Maine Medical Center on Nov. 15 because of injuries suffered after falling from a second-story window in the St. Joseph nursing office.

According to a DHHS statement of deficiency, at approximately 8 p.m. on Nov. 14, a St. Joseph employee discovered a female resident was missing from her room. During a search, the employee discovered that someone had locked the door to the facility’s nursing office from the inside. The employee retrieved a key from another location, and when she opened the door she noticed an empty wheelchair was sitting in front of an open office window.

The resident was found laying on the pavement 10 to 12 feet below the window. An employee at St. Joseph called an ambulance, which brought the resident to NMMC.

The report noted an employee recently removed an air conditioner from the same window in the nursing office, and a screen and pin used to secure the window were missing after the employee removed the air conditioner.

The author of the statement of deficiency wrote in the document: “… based on observations, interviews and record review, the facility failed to ensure that all forms of egress in the residents’ environment were secured and free from potential accidents for … resident (Resident no. 1) with a history of elopement behavior. This failure resulted in Resident no. 1 falling from an open window to the ground below. The resident sustained a life threatening injury, an intracranial hemorrhage, and expired.”

The department’s reference to “a history of elopement behavior” stems from nursing progress notes that revealed that, before the fatal accident, the patient successfully exited the building on two separate occasions and had tried to exit through a dining room window on another occasion.

In response to the deficiencies, St. Joseph administrators filed a plan of correction with DHHS in order to achieve compliance and avoid penalties, which include termination of participation in the Medicare and Medicaid programs. Remedies in the plan of correction include keeping the nursing office door locked after regular office hours and utilizing a new assessment form to help identify other patients who may be at risk for elopement.

The department accepted the plan of correction and said in a letter to St. Joseph that the facility is presumed to have achieved substantial compliance as of Nov. 25.

Citing patient confidentiality, Chad Cloutier, president of St. Joseph’s parent company, Davis Long Term Care Group Inc., said he was unable to respond to the specifics of the accident but said there is more to the case than the DHHS documents portray.

“St. Joseph’s has been a part of the St. John Valley community for decades and has provided great care to many of the residents of the St. John Valley without incident,” he said. “St. Joseph’s is an impeccable facility and was rated a five-star facility by the federal government for many decades. This is an unfortunate incident that occurred; however, there were certain factors involved in the choices made by the resident that precipitated that event. St. Joe’s is not in a position to comment on the health conditions of a particular resident; we take the privacy of our residents very seriously, so we would like to be able to disclose facts which might mitigate against public perception but we’re not in a position to mitigate against those facts because we’re not able to fully disclose what otherwise might explain the situation in a different way.”

Cloutier said this situation has been difficult for the staff at St. Joseph, whom he praised for their hard work and dedication in caring for patients at the facility, and added that the plan of correction is acceptable and easily implemented.

“I don’t believe that the measures that the state asked to come in would affect the outcome in this particular incident, but the modifications they asked for were simple remedies and we had no objection to doing it,” he said. “To be rated a five-star facility in a skilled long-term nursing facility, you obviously have to be operating your facility at the highest standards. Sometimes the unforeseeable happens and it’s a tragic loss for everyone, and our hearts go out to the family, and my heart goes out to the staff. They are probably the most affected by what has occurred.”