Before Washington County officials moved the mentally ill residents out of Garry McGrath's personal care home last summer, he told the state in an email that he feared "something tragic" would happen if they were placed somewhere without adequate supervision.
He said his fears were realized Nov. 25, when Sandra Mrock, 56, collapsed in a Donora facility -- perhaps while choking on food -- and died.
Ms. Mrock, a Washington, Pa., native, tried at various times to live on her own, but she cycled in and out of hospital psychiatric units and residential programs much of her life. Her relocation from the Monongahela personal care home, where staff were on duty around the clock, to a community residential rehabilitation facility, where relatives said she seemed to have only intermittent contact with caregivers, occurred against a backdrop of state budget cuts that have reduced help to people with mental illness.
The state Department of Public Welfare, which oversees mental-health services, said it has begun a review of Ms. Mrock's death and was to send inspectors to the Donora facility Friday.
Janice Taper, county administrator of behavioral-health and developmental services, declined to discuss Ms. Mrock but noted that accidents can happen to people with or without mental illness. Though relatives said Ms. Mrock seemed to have less supervision in Donora, Jeff Burks Mascara, executive vice president and CEO of Southwestern Pennsylvania Human Services Inc., which operates the facility through a subsidiary, disagreed.
Mr. Mascara said there is 24-hour supervision in the building where Ms. Mrock lived. However, he said he did not know whether a staff member was in the building at the time she collapsed. Family members said Ms. Mrock lay on the floor unaided for as long as 20 minutes. Mr. Mascara said a staff member found her within a couple of minutes.
County officials moved Ms. Mrock to the apartment about 21/2 months after Southwestern Pennsylvania Area Agency on Aging recommended she continue living in a personal-care home.
"And that's where they should have left her," said Ms. Mrock's sister, Lorraine Elias of Washington.
Mr. Mascara said a personal-care home and community residential rehabilitation facility differ primary in kinds of services, not level of supervision. While personal-care homes perform many services for residents, he said, the other setting helps residents learn skills for more independent living.
Ms. Mrock's death capped four decades of struggle with schizoaffective disorder. In addition, she battled chronic obstructive pulmonary disease, or COPD, and the lingering effects of a 2008 traffic accident.
Relatives traced Ms. Mrock's psychiatric problems to her teenage years.
Ms. Mrock's years of psychiatric treatment included a stay at Mayview State Hospital. At various times, she lived with her parents, in public housing and in her own apartments. She married and lost a son shortly after delivering him.
"She didn't even get to hold him before he died," Ms. Elias said. Ms. Mrock's former husband died in 2003.
Ms. Mrock eventually moved into a Bentleyville group home. It was a good program, relatives said, but tragedy marred that chapter of her life.
In April 2008, Ms. Mrock, eight other residents and two staff members climbed into a van for a trip to the Pittsburgh Zoo & PPG Aquarium. On a back-road intersection that had been the site of 15 accidents in five years, the van and a tractor-trailer collided.
Three residents and the two staff members died. Ms. Mrock, the other residents and the truck driver were injured.
Ms. Elias said her sister lay in the van for more than an hour until rescue workers freed her. After the accident, she said, her sister began having seizures.
In 2011, Ms. Mrock went to live at Anna's Home, the personal-care home that Mr. McGrath and business partner Gerald Sutyak operated.
In each of the three past years, a team from the Area Agency on Aging concluded in a one-page assessment that Ms. Mrock should live in a personal-care home. But a funding dispute interrupted her care.
After a 23 percent drop in funding over two fiscal years, Mr. McGrath said, he sought more money from county officials to operate the home.
The county and home owners were unable to resolve the funding issue. Ms. Taper said the residents were moved to other programs that met their needs. Mr. Mascara said Ms. Mrock and the others were accepted "with arms wide open."
Before Ms. Mrock and the other residents left the personal-care home, Mr. McGrath sent an email to the Department of Public Welfare, urging officials "to make assurances" that the new placements would provide appropriate supervision. He said he was concerned that "something tragic" would occur without 24-hour care.
Welfare Department spokeswoman Kait Gillis stressed this week that placement decisions are the county's prerogative.
On Nov. 25, Ms. Elias said, her sister apparently collapsed while eating a snack alone in a common area of the facility. She was taken to Monongahela Valley Hospital but could not be revived.
Ms. Gillis said the state recently learned of the death and launched an investigation immediately.
Joe Smydo: firstname.lastname@example.org or 412-263-1548.