Marvin ‘Pete’ Jacobs died Feb. 19, 2023, at the Fonda Care Center in northwest Iowa. According to state inspectors, he died after the care facility staff failed to suction his airway. (Facility photo via Google Earth; inset photo courtesy of the Jacobs family)
An Iowa nursing home where criminal charges were filed over a resident’s death is now being sued for negligence by the resident’s family.
The family of Marvin “Pete” Jacobs, who died in February 2023 at the Fonda Specialty Care nursing home in Pocahontas County, is suing the home’s corporate owners, Care Initiatives of West Des Moines; the home’s assistant director of nursing, Amanda Meyer; licensed practical nurse Becky Sue Manning; and GrapeTree Medical Staffing.
The family is seeking unspecified damages for gross negligence and negligent infliction of emotional distress. Criminal charges of wanton neglect are still pending against Manning, with a trial now scheduled for December.
State records indicate Jacobs was a resident at Fonda Specialty Care from September 2022 through Feb. 19, 2023. Jacobs required skilled nursing care for maintenance of the tracheostomy tube in his neck, which provided an airway for him to breathe. According to the family’s lawsuit, Jacobs’ airway needed to be suctioned every eight hours, at minimum, to keep it clear of any fluids.
‘Watch a video and figure it out’
According to the lawsuit, Manning arrived for work at Fonda Specialty Care on the afternoon of Feb. 18, 2023. GrapeTree Medical Staffing, a temporary-staffing agency that specializes in health care, had assigned her to work an overnight shift in the home. When she became aware Jacobs had a tracheostomy that would require suctioning at some point during the night, Manning allegedly told Meyer and others she was unwilling or incapable of performing the work.
As assistant director of nursing, Meyer allegedly knew that no other employees at the home that night were licensed or trained to provide tracheostomy care, the lawsuit claims. Despite that, Meyer allegedly told Manning to “watch a video and figure it out” and left the facility for the day.
According to state records, two certified nursing assistants called Manning to Jacobs’ room at 2 a.m., informing her Jacobs needed his airway suctioned. One of the CNAs later told state inspectors Jacobs had been sitting in his recliner when the other CNA noticed he appeared to be “in trouble” and instructed her to get a nurse right away. Jacobs was pointing at his neck, gasping for air, and mouthing that he could not breathe, the aide told inspectors.
The aide said she left the room to get Manning, the only nurse on duty, and was absent for a few minutes. The worker who remained in the room later told inspectors Jacobs grew “really pale” and was gasping, so she, too, left the room and approached Manning and said, “Would you please suction him? He needs to be suctioned.”
When Manning entered the room, Jacobs was pale, but soon turned purple and then blue, the aide later reported. Manning allegedly took Jacobs’ vital signs and told the aide Jacobs was having a heart attack. The aide explained to Manning that Jacobs had been signaling he couldn’t breathe, at which point Manning allegedly said, “Just a minute,” and left the room. The machine used to suction Jacobs’ airway sat idle on a nearby dresser, inspectors later determined.
‘You know he’s dead, right?’
By 2:28 a.m., with no other employees having suctioned Jacobs’ airway, he showed no signs of breathing. At 2:40 a.m., an ambulance crew arrived at the home. According to inspectors, when the ambulance crew entered the building, they were greeted by two employees who stated, “You know he’s dead, right? Just come in and talk with the charge nurse, don’t bring in any equipment.”
Jacobs’ cause of death was later attributed to a heart attack caused by hypoxia — a lack of oxygen — with no other contributing causes or significant conditions listed on the death certificate.
Manning allegedly told state inspectors that the CNAs “wanted me to suction him (and) I told the staff, ‘No, I was told that I would not have to do anything with the tracheostomy.’” Pocahontas County prosecutors allege that no fewer than four workers asked Manning to suction Jacobs’ airway and that the workers alerted Manning to the fact that Jacobs was asking to be suctioned.
After the death, the lawsuit claims, Manning falsely informed Jacobs’ son, Scott, that his father “went quickly and peacefully.” Scott Jacobs only learned of what actually transpired after being contacted by an Iowa Capital Dispatch reporter, the lawsuit claims.
The lawsuit alleges that after speaking to the reporter, Scott Jacobs called Jennifer Blair of Care Initiatives “to confront her about the (state’s) investigation and true facts of Pete Jacobs’ death.” According to the lawsuit, Blair “admitted to withholding information” from the family and not informing them of the state’s investigation and its findings.
On April 1, 2023, Scott Jacobs requested a copy of his father’s complete medical record, but according to the lawsuit he didn’t receive it for a full year due to Care Initiatives’ “delay and obfuscation.”
Care Initiatives has yet to file a response to the lawsuit and has declined to comment on Jacobs’ death. The company has a policy of not commenting on pending litigation, a spokesperson said.
Death results in $6,500 fine
Manning was criminally charged in March with felony wanton neglect of a health care facility resident. A trial, originally scheduled for July, has been postponed several times. Court records indicate the defense has been pursuing plea negotiations with prosecutors.
In late April, Manning entered into an agreement with the Iowa Board of Nursing in which she agreed to indefinitely suspend her practice of nursing.
The Iowa Department of Inspections and Appeals fined Fonda Specialty Care $10,000 for the death, then reduced that penalty 35%, to $6,500, due to the lack of an appeal in the case.
In August, the Iowa Capital Dispatch reported that Care Initiatives, which is one of Iowa’s largest nursing home operators, was facing at least 10 wrongful death lawsuits. The lawsuits, all filed in state court over the previous 18 months, included four against Northcrest Specialty Care in Waterloo, which has been the focus of at least 21 complaint investigations by the state in the previous 15 months.
Care Initiatives operates 43 Iowa nursing homes as well as several assisted living centers and hospice locations. Roughly 2,800 elderly or disabled Iowans receive care from one of the company’s facilities. When admitted, many of the company’s residents sign arbitration agreements in which they forfeit their right to take any civil claims against the company to court.
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 Donald Trump took office, that appeal was dropped and CMS proposed a new rule that expressly allows such agreements. In 2019, that rule was finalized, and it remains in place today.