HHS-OIG Imposes Penalties on Skilled Nursing Facilities for Employing Excluded Individuals
The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) has recently announced enforcement actions against entities alleged to have employed excluded individuals who provided items or services that were billed to federal healthcare programs. On May 29, 2025, HHS-OIG announced a $1,565,374.11 settlement agreement with 19 skilled nursing facilities to resolve allegations that they knew or should have known that they employed individuals who were excluded from federal healthcare programs.
| Sundance Creek Post Acute, California | Escondido Post Acute, California |
| Jurupa Hills Post Acute, California | Crystal Cove Care Center, California |
| Redwood Cove Healthcare Center, California | Huntington Valley Healthcare Center, California |
| Houston Transitional Care, Texas | Napa Post Acute, California |
| Norwood Towers Post Acute, Ohio | Sunnyvale Post Acute Center, California |
| Stoney Point Healthcare, California | Trellis Centennial, Nevada |
| San Diego Post Acute, California | Mirage Post Acute, California |
| Crystal Ridge Care Center, California | Aviara Healthcare, California |
| Concord Post Acute, California | Westview Healthcare Center, California |
| Balboa Nursing & Rehabilitation Center, California |
The second settlement agreement involved a $35,597.37 penalty for CareLink Home Health, LLC in Illinois for employing an excluded individual who worked as a nurse and case manager when that individual was on the exclusions list.
HHS-OIG can exclude individuals and entities from federally funded healthcare programs such as Medicare and Medicaid for a variety of reasons. The length of time an individual or entity is excluded depends on the reason for exclusion, with the longest terms typically for Medicare and Medicaid fraud convictions. For example, a Michigan man was recently excluded for 10 years for submitting false claims for pharmaceuticals that were never dispensed. For repeat offenders, exclusion may be permanent.
For some offenses, there is no minimum exclusion period; for instance, HHS-OIG may exclude an entity for defaulting on its payment obligations under a settlement agreement. The entity will remain on the list at the discretion of HHS-OIG and will not be eligible for reinstatement until the default of their payment obligations is cured.
HHS OIG Exclusions List
What You Need To Know
Get The 6 Essentials Checklist For Compliance Officers
A link to your download will be sent to your email address
Your Privacy Respected
HIPAA Journal Privacy Policy
Healthcare organizations must check the HHS-OIG List of Excluded Individuals/Entities (LEIE) before any new hire or onboarding of a new vendor, and should also regularly check the LEIE to ensure that current employees and vendors are not excluded to avoid CMP liability.
