Iowa nursing home operator faces more wrongful death claims

One of Iowa’s largest nursing home operators, Care Initiatives of West Des Moines, is currently facing at least 10 wrongful death lawsuits.

The lawsuits, all filed in state court over the past 18 months, include four against Northcrest Specialty Care in Waterloo, which has been the focus of at least 21 complaint investigations by the state in the past year.

In each of the lawsuits, Care Initiatives has denied any wrongdoing. The company, which operates 43 Iowa nursing homes as well as several assisted living centers and hospice locations, says it does not comment on pending litigation. Roughly 2,800 elderly or disabled Iowans receive care from one of the company’s facilities.

In several of the lawsuits, Care Initiatives has attempted to have the cases thrown out of court due to contracts residents signed at admission. Those contracts call for any disputes between the residents and the company to be settled through private arbitration rather than civil litigation.

Such agreements have generated controversy nationally, with advocates for seniors arguing that residents and their family members often don’t understand the contracts may result in them losing their right to sue.

Earlier this year, an Iowa judge refused to dismiss a wrongful death lawsuit filed by the family of the late Janice Schmitt against Northcrest — despite Schmitt having signed an arbitration agreement when she was admitted.

The lawsuit alleges that just one day after Schmitt was admitted, she fell and sustained a brain hemorrhage, extensive facial fractures and a broken wrist. Four days later, she was dead, with the official cause of death listed as multiple injuries that resulted from the fall.

In his ruling, District Court Judge David Odekirk stated that the manner in which the arbitration agreement was offered to, and signed by, Schmitt was “unconscionable.” He noted that Northcrest’s own staff had evaluated Schmitt just prior to her signing the agreement on Sept. 23, 2022.

Odekirk found that the Northcrest staff had determined, at 12:47 p.m., that Schmitt was “not oriented to place, time or situation,” had impaired decision-making ability and, possibly, dementia.

At 2:26 p.m. that day, Odekirk noted, Schmitt electronically signed her admission paperwork and then, nine seconds later, she signed a “Voluntary Agreement to Resolve Disputes by Binding Arbitration.”

“Northcrest either knew, or should have reasonably known, that Ms. Schmitt was unable to reasonably protect her interests by reason of her mental infirmities evidenced by the objective findings of her lack of orientation to place, time, or situation,” Odekirk ruled in allowing the Schmitt family’s lawsuit to go forward. “It is not enough that the language of the arbitration agreement was in bigger print or all caps. The court finds this is the equivalent of talking louder and slower to a person who is either deaf or a non-English speaker and expecting that to be sufficient to ensure understanding.”

A jury trial in the case is now scheduled for Feb. 17, 2026.

Obama-era proposal blocked

The number of active lawsuits Care Initiatives is currently facing is roughly the same as in 2021, when the Iowa Capital Dispatch first reported on the company’s use of arbitration agreements, which are common in the nursing home industry.

At that time, it was estimated that close to 70% of all nursing home residents nationally had signed arbitration agreements that limited, if not eliminated, their right to sue for p0or quality care and forced them to have disputes settled through private arbitration.

A 2019 report by the American Association for Justice found that consumers generally have a better chance of being hit by lightning than winning any monetary award through the arbitration process.

In 2016, the Obama administration approved a new rule proposed by the Centers for Medicare and Medicaid Services that would have prohibited Medicare-funded homes from having residents sign arbitration agreements.

The American Health Care Association immediately sued CMS and a court blocked the agency’s enforcement of the new rule.

The Obama administration appealed that ruling but shortly after President Trump took office, that appeal was dropped and CMS proposed a new rule that expressly allowed such agreements.

In 2019, that rule was finalized, and it remains in place today. Although it allows arbitration agreements, it prohibits nursing homes from requiring residents to sign them as a condition of admission.

Among the lawsuits Care Initiatives is currently facing:

Southridge Specialty Care, Marshalltown: The family of Larry Nichols alleges that within a few weeks of his admission to Southridge in March 2022, he suffered from sepsis and septic shock caused by the staff’s failure to treat pressure sores and wounds. Nichols died on July 24, 2022. In response to Care Initiatives’ efforts to have the case dismissed due to an arbitration agreement, Nichols’ daughter, Teri Mayer, told the court her father never attended college, had no understanding of contracts or arbitration agreements, and also suffered from a significant loss of vision.

“My father was incapable of understanding what an arbitration agreement is,” Mayer told the court. “Even if a contract was read to my father line by line, he was incapable of understanding any legal implications of such a contract.”

The judge in the case, noting that Nichols had allegedly reviewed 42 pages of admissions documents in 11 minutes when he was admitted, ruled there wasn’t enough evidence available to determine whether the agreement was enforceable. He ruled there should be a trial on the issue of the agreement’s validity before the larger case against Southridge could proceed. That trial is scheduled for Oct. 15, 2024.

Northcrest Specialty Care, Waterloo: The family of Lora Pavlovec alleges she was admitted to Northcrest in January 2022 after which the home failed to provide sufficient, qualified staff to meet her needs, specifically as related to skin care and the prevention of pressure sores. That alleged failure, the lawsuit claims, resulted in severe pain, septic shock and, in May 2022, Pavlovec’s death. A trial is scheduled for Aug. 27.

Corning Specialty Care: The family of Angela Segebart alleges that she was admitted to the Corning home in September 2017 and that on Jan. 20, 2022, she tested positive for COVID-19. On Jan. 27, 2022, the staff allegedly dropped Segebart while transferring her in or out of bed, resulting in two broken legs. The lawsuit claims the staff then failed to assess Segebart’s injuries and placed her back in bed. Two days later, she was experiencing respiratory problems and was transferred to a hospital where she subsequently died.

The official cause of Segebart’s death was chronic respiratory failure and pneumonia due to COVID-19, with sepsis and acute renal failure listed as contributing factors. Care Initiatives successfully fought to have the bulk of the case settled through arbitration, although the family’s claim of loss of consortium could result in further litigation depending on the outcome of arbitration.

Wapello Specialty Care: The family of Alice Ward alleges that after she was admitted to the Wapello home in June 2021, she was deemed to be at a high risk for falls. In February 2022, she allegedly wandered from the home, fell and sustained a neck fracture and head wound, and then died five days later. The judge in the case has stayed the court proceedings pending the outcome of arbitration.

Northcrest Specialty Care, Waterloo: The family of John Nichols alleges he was admitted to Northcrest on Feb. 8, 2022, and, eight days later, fell while in the shower. Nichols was taken to a hospital where he allegedly died hours later due to a brain bleed attributed to the fall. Care Initiatives successfully fought to have most of the family’s claims settled through arbitration, although a loss-of-consortium claim could result in further litigation depending on the arbitrator’s decision.

Avoca Specialty Care: The family of Craig Christensen alleges that while living at the Avoca facility in January 2022, Christensen developed a urinary tract infection that was left untreated and led to the development of sepsis and septic shock and, ultimately, his death on Feb. 20, 2022. A jury trial is scheduled for July 29, 2025.

Corydon Specialty Care: The family of Gloria August alleges that she was admitted to the Corydon home in January 2020 at the age of 88. In December 2021, after numerous falls at the home, the last of which resulted in a significant injury, August died, the lawsuit claims. In October 2023, a hearing was held on Care Initiatives’ motion to have the case handled in arbitration. Five months later, a judge ruled on the motion by allowing the case to proceed – although the issue of whether the case will have to be settled through arbitration has yet to be decided.

Northcrest Specialty Care, Waterloo: The family of Georgia Demuth alleges she died in June 2021 as the result of Northcrest’s failure to provide adequate care. A jury trial is scheduled for June 24, 2025.

Parkridge Specialty Care, Pleasant Hill: The family of Neuang Boun Sisamouth alleges that on June 20, 2022, the staff at Parkridge failed to respond to her deteriorating condition, despite dangerously low blood sugar levels. Licensed Practical Nurse Dezaree Major failed to call 911 as ordered, and there was a 90-minute delay in transporting Sisamouth to the hospital where she was pronounced dead a short time later, the lawsuit claims. A trial date has yet to be scheduled.

In 2022, the Iowa Board of Nursing ordered Major to complete 30 hours of continuing education. According to the board, Major was working at unspecified Iowa nursing home in 2021 where, for five months, she falsified various medical records and performed nursing services beyond the scope of her license.