The investigations of Van Putten's care have left the family even further outraged. In December, more than a year after the family filed its initial complaints, CMS said in a letter to them that it had "identified many troubling elements" in how the family's complaints were handled. CMS says it plans to conduct training of its state survey agencies, like the Virginia Department of Health, and its own regional offices in response.
But the letter offers few specifics, and CMS officials declined to comment on the letter.
The Van Puttens say the letter from CMS raises more questions than it answers, especially considering that last month CMS wrote a letter to the Virginia Department of Health complimenting VDH on its handling of the Van Putten investigation, saying regulators were "very proactive and responsive to these investigation requests."
Promises by CMS officials to the Van Puttens to address their concerns have been ignored, the family said.
"It feels like a cover-up," said Sharon Van Putten's daughter, Vicki Ruiter of Centreville.
Health documents can also be exempt from release if they would invade a patient's privacy, but the hospital inspections produced by Virginia do not release any individual information about patients.
Rhyne said she becomes concerned when categories of documents that were previously publicly available suddenly become off limits.
"It immediately raises suspicions about what's being done and why," she said.