Nursing homes operated by Life Care Centers of America, one of the largest chains in the industry, violated federal standards meant to stop the spread of infections and communicable diseases even after outbreaks and deaths from Covid-19 began to sweep its facilities from the Pacific Northwest to New England, inspection reports show. To experts and advocates, the size of the outbreaks reflects profound flaws in the company’s management and the treatment of patients, which have been documented for years in lawsuits by families, former employees and federal prosecutors. Time and again, they described a company beset by staffing shortages and compromised care, deficiencies that critics say probably worsened as covid-19 infected hundreds of residents and caregivers.
As the nationwide death toll among the elderly soared, government inspectors discovered breakdowns in infection control and prevention at at least 10 Life Care nursing homes that underwent covid-19 inspections overseen by the Centers for Medicare and Medicaid Services. That does not include deficiencies found at the Life Care Center of Kirkland in Washington state, which suffered the country’s first reported outbreak of the novel coronavirus in February.
At other Life Care nursing homes, inspectors have since then discovered staff members who did not wash their hands or enforce social distancing guidelines, according to the inspection reports. At one home in Denver on May 5, staffers left open the door of an isolation room, allowing a patient with covid-19 to slip into the hallway without a face mask and sit next to a room with two healthy residents. At another home in Colorado, a nursing assistant hovered 12 inches from the face of a coughing patient who was not wearing a mask. In Kansas, inspectors found a nursing home’s infection control log failed to include two patients with fevers — one was sent to the hospital with a 103-degree fever and died. In a home in Michigan, a nursing assistant rolled a blood pressure machine out of an isolation room and into a non-covid-19 room without sanitizing the equipment. At another Michigan home, inspectors found residents in a hallway who were not wearing masks and an aide who delivered meals without wearing gloves or a gown, even though the residents were at risk of respiratory infection.
“These deficient practices resulted in the high liklihood of spreading coronavirus and harmful pathogens among five residents . . . second floor residents that received direct care from staff, second floor residents that interacted with each other, residents that resided on the first floor that received food from the kitchen and nine residents that transferred to the hospital testing positive for covid-19,” the inspector wrote.
Life Care President Beecher Hunter said “Life Care Centers of America and its affiliated facilities are not perfect; no organization is because it is made up of people, and people are imperfect human beings,” Hunter said in an email to The Post. “. . . Our healthcare heroes will from time to time unfortunately fall below our standards for resident care.”
In the past three years, dozens of Life Care homes received below-average staffing ratings or were flagged during inspections for not having enough nurses to properly care for patients, according to CMS. Forrest Preston, the son of a Massachusetts pastor, settled in southeastern Tennessee in the 1950s to help his brother create booklets and public relations material for hospitals. Over time, he developed an interest in long-term care. Preston and his partners opened the first nursing home in 1970. From his Tennessee headquarters, the company would grow to more than 200 nursing homes, one of the largest networks in the country.
The Justice Department in recent years accused the company’s billionaire owner of leaving Life Care “severely undercapitalized” while engaging in a “systematic scheme to maximize its Medicare billing.” Prosecutors say Life Care subjected patients to excessive, unnecessary and “sometimes even harmful” rounds of rehabilitation therapy to draw Medicare dollars and chastised or punished those who complained the practice undermined the judgment of therapists at the expense of patients.
The company settled with the Justice Department in 2016 for $145 million — the largest settlement with a skilled nursing chain in the department’s history. Life Care also entered into a five-year corporate integrity agreement with the inspector general of the Department of Health and Human Services, which required an independent annual review of the company. Life Care was in its fourth year of the agreement when the coronavirus struck the United States.
Families, lawmakers and former and current employees say Life Care, after years in operation and amid intense scrutiny, should have done far more to protect patients and caregivers as the pandemic intensified.
“We kept waiting and waiting for them to do something, and they never did,” said Diane Crowley, who worked at the front desk at the nursing home, wiping her hands with a cloth soaked in bleach that she said she kept in a plastic bag in her pocket. She eventually quit. “I was literally surrounded by covid,” she said. “I just told my kids, ‘Please never put me in one of those places. These people live their whole lives — there are teachers, poets and everything else — and this is what they’re ending their lives with?’ ”