A federal watchdog said a lack of communication by the Centers for Medicare & Medicaid Services may have caused infection control deficiency citations at Life Care Centers of America nursing homes between Jan. 2019 and May 2020.

The US Department of Health and Human Services’ Office of the Inspector General audited more than 20 of the chain’s 200 facilities and in March 2021, CMS officials said the nursing homes had satisfactorily addressed all of the deficiencies.

LCCA is the third-largest nursing facility chain in the U.S., with more than 200 facilities and locations in 27 states, and more than 27,000 skilled nursing beds.

LCCA acknowledged reasons for the deficiencies that included staff and leadership turnover, documentation issues and staff members unfamiliar with requirements. The operators also noted there were shortages of qualified staff and various COVID 19-related obstacles, but it said that the OIG said CMS bore some responsibility.

“We also believe that many of the conditions noted in our report occurred because CMS did not provide nursing homes with communication and training related to complying with the new, phase 3 infection control requirements, or clarification about the essential components to be integrated in the nursing homes’ emergency plans,” OIG report authors said.

In a recent audit completed in June 2022 and but only made public Thursday (Sept. 15), the OIG said the LCCA properties may have failed to comply with federal requirements for infection prevention and control. LCCA cooperated with OIG documentation requests, the agency noted.

In addition, OIG said that at 22 LCCA nursing homes, it found 35 instances of possible noncompliance with infection prevention and control requirements related to:

*Annual reviews of the infection prevention and control program;


*Designation of a qualified infection preventionist;

*Quality Assessment and Assurance Committee meetings. 

The audit also concluded that 16 nursing homes produced 20 instances of possible noncompliance with emergency preparedness requirements related to the annual review of emergency preparedness plans and annual emergency preparedness risk assessments.

The OIG said it looked at SSA information on Medicare.gov for the most recent standard surveys and the previous 12 months of complaint surveys. From that analysis, the OIG determined that 6,622 nursing homes had been cited for infection prevention and control program deficiencies as of Feb. 26, 2020. Medicare.gov noted that 24 of those nursing homes across 11 states were part of the LCCA chain.

CMS did not respond to McKnight’s questions Monday about the OIG’s suggestion that it failed to provide enough information. LCCA said in a statement to McKnight’s:

“Life Care and its facilities, along with all skilled nursing facilities across the country,

have dealt with – and continue to deal with – unprecedented industry challenges as a

result of the COVID-19 pandemic. Throughout the course of the pandemic, Life Care

facilities and staff have continually updated and revised their policies, procedures, and

practices as guidance from the CDC, CMS, and state and local health agencies have


The report recently issued by the Office of Inspector General does not reflect or relate to

Life Care and its facilities’ response to COVID-19. Instead, the report relates to the

technical compliance by select Life Care facilities with respect to regulatory requirements

that were promulgated in 2016, before the emergence of COVID-19.

Nonetheless, the report does appropriately spotlight the challenges that every health care

facility in the nation have faced during this pandemic. COVID-19 has touched the lives

of all Americans, but especially the elderly. Our facilities, and more importantly our staff

members, continue to focus on the enhancement of our clinical product, while ensuring

compliance with infection prevention and control and emergency preparedness


Life Care’s focus has, is and will continue to be the well-being of its patients, staff, and