A Tennessee-based skilled nursing provider is facing a False Claims Act complaint after it allegedly submitted claims for services that were “grossly substandard” or not provided at all over a five-year span, federal officials announced Wednesday.

Vanguard Healthcare LLC, six of its facilities and a former director of operations were targeted in the case filed by the U.S. Department of Justice. In addition to false claims allegations, the case includes accusations that the company submitted pre-admission documents with forged physician and nurse signatures.

The six facilities named in the complaint, all located in Tennessee, were reportedly plagued by chronic staffing and supply shortages and “failed to provide the most basic and essential skilled nursing services to their residents,” the complaint reads. The individual facilities were also accused of failing to provide infection control, properly administer medications, provide wound care, and adequately manage residents’ pain.

Vanguard residents suffered pressure ulcers, falls, malnutrition, dehydration and other harms as a result of the substandard care, according to DOJ officials. Additional allegations include claims of excessive and unnecessary use of psychotropic medications and physical restraints.

Mark Miller, who served as the director of operations for Vanguard from 2012 to 2014, was singled out in the case for allegedly knowing resident care was “non-existent or grossly substandard” but failing to address the issue.

“Vanguard Healthcare cannot address specific questions regarding pending litigation other than to express our confidence the claims by the Department of Justice are without merit, and Vanguard will vigorously defend its position,” a Vanguard spokeswoman said in a statement to McKnight’s.  “We are committed to the consistent delivery of high-quality care, and meeting the needs of the residents and communities we serve remains our highest priority.”

The six Vanguard-managed facilities named in the complaint filed for Chapter 11 bankruptcy in May, federal officials said. Those facilities include Boulevard Terrace Rehabilitation and Nursing Center in Murfreesboro, TN; Crestview Health and Rehabilitation in Nashville, TN; Glen Oaks Health and Rehabilitation in Shelbyville, TN; Manchester Health Care Center in Manchester, TN; Poplar Point Health and Rehabilitation in Memphis, TN; and Imperial Gardens Health and Rehabilitation, which is no longer in operation, in Madison, TN.

Vanguard manages a total of 14 skilled nursing facilities in Florida, West Virginia, Mississippi and Tennessee, according to its website.