Life Care Center (LCC) of Kirkland is facing more than $600,000 in fines for its response to the COVID-19 outbreak in its facility.

LCC of Kirkland is the site where the COVID-19 outbreak started in the United States.

On April 1, the Centers for Medicare & Medicaid Services (CMS) contacted the Kirkland center to inform them that following a survey of the facility, LCC of Kirkland is being penalized $13,585 per day for Feb. 12 through March 27, for a total of $611,325. According to the communication between CMS and LCC of Kirkland, the center must either pay the fines or correct the deficiencies CMS found in its survey by Sept. 16. If LCC of Kirkland does not do this, the facility will be terminated.

CMS notified LCC of Kirkland on March 18 that the agency, along with the Washington state Department of Social and Health Services (DSHS) state survey agency, completed a complaint survey at the facility on March 16 and informed LCC of Kirkland of its immediate jeopardy (IJ) disposition. IJ is a situation “in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident,” according to CMS.

“Based on those survey results, CMS determined that LCC of Kirkland no longer met the requirements for participation as a provider of services in the Medicare program established under Titles XVIII and XIX of the Social Security Act,” the communication reads.

CMS also notified the Kirkland facility that it would be terminating its Medicare provider agreement on April 8 if the center failed to remove the IJ findings before that date.

Out of immediate jeopardy

In a prepared statement, LCC of Kirkland wrote that over the weekend of March 28, the center “successfully worked with CMS to remove three Immediate Jeopardy citations. We will continue to work with CMS to find solutions to their ongoing concerns.”

The first IJ citation LCC of Kirkland received related to the “lack of timely action in [implementing] infection control procedures,” a lack of a plan for provision of emergent services to meet the increased needs of acutely ill residents and a lack of “clinical evidence of physician and/or extender evaluations and interventions.” According to CMS findings, these contributed to “a failure to provide the necessary resources to effectively manage the respiratory outbreak and deliver optimal quality of care and services to these residents.”

The second citation related to “failure to have emergency physician services available 24 hours per day or to have an alternate emergency plan.”

The third IJ citation related to “failure to perform infection control surveillance with identifying a respiratory infection and pneumonia outbreak and failure to ensure timely reporting of the outbreak to the Department of Health.”

As a result of these IJ citation removals, the April 8 CMS deadline was extended to Sept. 16.

Working together to address concerns

While LCC of Kirkland has removed its IJ citations, there are other deficiencies the center must address.

For the three IJ citations, the facility remains noncompliant “at the severity level of no actual harm with potential for more than minimal harm…because a significant portion of staff (71 staff, 57%) had not yet returned to work to complete training and the facility had not yet demonstrated sustained compliance and integration with their quality assessment and performance improvement program.”

Other areas LCC of Kirkland must address in order to avoid fines and/or closure include meeting requirements regarding its governing body, medical director, resident records and quality assessment performance improvement program.

According to its statement, LCC of Kirkland receives routine visits from CMS to ensure it is “following the correct protocols to ensure quality resident-centered care,” according to the statement, noting that prior to this, the center received a five-star overall rating from CMS, the highest rating given to nursing homes.

“The [CMS] has been a valuable partner to us over the years as we continue to make patient care our top priority,” the statement from LCC of Kirkland reads.

In addition to “working hard to address [CMS’] current concerns in a timely and respectful manner so as to provide [their] residents the best care,” LCC of Kirkland plans to dispute some of the findings by CMS.

“The federal administrative process provides a means for us to dispute any findings which we believe are incorrect, and we believe some are here,” the statement reads. “However, we will follow CMS’ process and not address our responses in the public.”

According to CMS, LCC of Kirkland has 10 days to do so from the time it received the notice of the CMS survey results.