RICHMOND, VA — A multi-facility nursing home organization operating in Virginia alleged that a state health inspector demonstrated bias against its properties while conducting federal compliance surveys that resulted in serious violation findings at multiple locations, according to internal communications obtained through public records requests.
Medical Facilities of America (MFA) sent formal complaints to the Virginia Department of Health during 2025 detailing what the company's chief operating officer characterized as a pattern of unprofessional conduct by an inspector during surveys at several affiliated nursing homes. The complaints emerged as some facilities received high-level citations for care deficiencies, with one location ultimately losing its federal funding eligibility due to persistent safety violations, as reported by CBS 6.
The company's chief operating officer, Craig Neiswanger, submitted a letter to state licensing officials in June 2025 outlining concerns about an inspector's alleged comments during surveys at MFA-affiliated facilities. According to the correspondence, the inspector allegedly made statements about facility ownership and suggested that the organization would continue receiving serious citations unless corporate investment increased. The inspector's name was redacted from documents released by the Centers for Medicare and Medicaid Services in January 2026, following a months-long records request process.
Pattern of Alleged Comments
The allegations centered on remarks allegedly made during multiple nursing home inspections throughout 2024 and 2025. During an April 2025 survey at Parham Health Care and Rehabilitation Center, which resulted in citations related to repeated willful abuse of residents and associated financial penalties, the inspector allegedly told facility staff that ownership knew the company operated as a family business and that lack of corporate investment would lead to continued high-level violations and fines, according to Neiswanger's complaint.
At Colonial Heights Rehabilitation and Nursing Center in May 2025, the same inspector allegedly referenced the facility's ownership structure following an inspection conducted several months after staff arrests in an elder abuse investigation that received media attention, as reported by local news outlets. Neiswanger stated in his letter that the facility operated as a standalone entity receiving management consultation from MFA.
Additional alleged comments occurred during an October 2024 survey at Virginia Beach Healthcare and Rehab Center, where the inspector allegedly stated that surveyors would begin issuing high-level citations "everywhere to force your company into doing what we want," according to the complaint. That inspection resulted in findings that residents received substandard care quality due to failures across multiple systems including sanitation, infection control, and abuse prevention, with associated federal penalties.
Facility Sanctions and Federal Action
The situation escalated when the inspector conducted a survey at Princess Anne Health and Rehab Center in August 2025. That inspection identified high-level violations related to inadequate resident supervision that led to injuries in some cases, according to federal inspection reports. During that survey, the inspector allegedly made disparaging comments about facility administration, according to Neiswanger's second complaint letter sent to state officials.
The Centers for Medicare and Medicaid Services subsequently terminated Princess Anne Health and Rehab Center from Medicare and Medicaid programs, an enforcement action that CMS characterizes as extremely rare and reserved for facilities that fail to meet basic health and safety requirements. Federal program termination effectively eliminates a nursing home's ability to receive payment for most residents, as the majority of nursing home patients rely on Medicare or Medicaid coverage.
Company Response and State Engagement
In his initial June 2025 letter, Neiswanger requested that the Virginia Department of Health temporarily prohibit the inspector from conducting surveys at MFA nursing homes, characterizing the alleged behavior as unprofessional. According to his communications, state officials met with company representatives regarding the concerns, and Neiswanger indicated he found the meeting productive.
However, the August 2025 letter indicated that the same inspector was assigned to conduct the Princess Anne survey, prompting renewed concerns from the company. The records obtained through the public information request did not include any response from the Virginia Department of Health or documentation of actions taken regarding the allegations.
CMS identifies Medical Facilities of America as a nursing home chain operating multiple locations in Central Virginia. According to federal quality ratings, most facilities associated with the organization have low overall quality and staffing ratings on the CMS Five-Star Quality Rating System. Federal records indicate these nursing homes now operate under the chain designation "Lifeworks Rehab," which state officials described as a rehabilitation vendor providing services within MFA facilities.
Regulatory Oversight Context
Federal regulations require state health departments to conduct surveys of nursing homes participating in Medicare and Medicaid programs to ensure compliance with federal care and safety standards. Surveyors assess facilities across numerous care areas including nursing services, medication management, infection control, resident rights, and quality of life provisions.
When surveys identify deficiencies that pose immediate jeopardy to resident health and safety or constitute a pattern of substandard care, federal regulations allow CMS to impose remedies including financial penalties, denial of payment for new admissions, temporary management, and in severe cases, termination from federal programs. Federal data shows that program terminations occur in less than one percent of enforcement actions nationally.
Resources for Families
Families with concerns about care quality at Virginia nursing homes can contact the Virginia Long-Term Care Ombudsman Program, which provides independent advocacy for residents. The program investigates complaints and works to resolve issues related to care, resident rights, and facility operations.
The National Long-Term Care Ombudsman Resource Center operates a hotline at 1-800-677-1116 for families seeking guidance about nursing home concerns or the complaint process. Additional information about ombudsman services is available at ltcombudsman.org.
Families can also report concerns directly to the Virginia Department of Health's Office of Licensure and Certification, which investigates complaints about licensed healthcare facilities. Federal regulations require facilities to prominently display information about how to contact state survey agencies and ombudsman programs.
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