Thu. Jan 9th, 2025

A wrongful death lawsuit against the Fonda Specialty Care nursing home should not be allowed to proceed, the home argues, due to an arbitration agreement signed by the deceased’s family. (Facility photo via Google Earth; document courtesy of Iowa Judicial Branch.)

A wrongful death lawsuit against an Iowa nursing home should be tossed out of court due to an arbitration agreement signed by the man’s family, the home’s owners claim.

In February 2023, Marvin “Pete” Jacobs died at the Fonda Specialty Care nursing home where he had lived for six months with a tracheostomy tube that provided an airway for him to breathe. According to state records, Jacobs’ airway needed to be suctioned every eight hours, at minimum, to keep it clear of any fluids.

State inspection reports indicate that in the minutes leading up to Jacobs’ death, a nurse at Fonda Specialty Care, Becky Sue Manning, refused several staff requests to clear Jacobs’ airway so he could breathe, and that Jacobs suffocated as a result.

Marvin ‘Pete’ Jacobs of northwest Iowa. (Photo courtesy of the Jacobs family)

Last March, Manning was criminally charged with felony wanton neglect of a health care facility resident. Recently, Manning and Pocahontas County prosecutors agreed to a deal that resulted in Manning entering an Alford plea to a reduced charge of misdemeanor wanton neglect that did not result in a serious injury.

Manning is scheduled to be sentenced on Jan. 13.

In October, the Jacobs family sued Manning, Fonda Specialty Care, the home’s corporate owner, Care Initiatives of West Des Moines, and GrapeTree Medical Staffing for a variety of claims related to Jacobs’ death.

The defendants in the case recently filed motions with the court to have any further proceedings in the case stayed, arguing that when Jacobs was admitted his son signed several documents, including one in which he waived the family’s right to sue for negligent care so that any such disputes could be settled through arbitration. The arbitration agreement, the defendants say, was not a prerequisite for admission.

The family’s attorney has yet to file a response to those motions.

Care Initiatives operates 43 Iowa nursing homes as well as several assisted living centers and hospice locations that provide 2,800 elderly or disabled Iowans with care. When admitted, many of the residents sign arbitration agreements in which they forfeit their right to present any civil claims against the company to a judge or jury.

In 2016, the Obama administration approved a new rule proposed by the Centers for Medicare and Medicaid Services that would have prohibited taxpayer-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.

Care Initiatives is currently facing at least 10 wrongful death lawsuits, including four against Northcrest Specialty Care in Waterloo. In each of the lawsuits, Care Initiatives has denied any wrongdoing and in several of the cases it has attempted to have the cases thrown out of court due to arbitration agreements.

‘Watch a video and figure it out’

According to state inspectors and a lawsuit filed by Jacobs’ family, Manning had arrived for work at Fonda Specialty Care on the afternoon of Feb. 18, 2023, after GrapeTree, a temporary-staffing agency, assigned her to work an overnight shift in the home.

When Manning became aware Jacobs had a tracheostomy that would require suctioning at some point during the night, Manning allegedly told the home’s assistant director of nursing she was unwilling or incapable of performing the work.

The assistant director of nursing allegedly told Manning to “watch a video and figure it out” and left the facility for the day. At around 2 a.m. that night, Jacobs was allegedly sitting in his recliner when an employee noticed he was pointing at his neck, gasping for air, and mouthing that he could not breathe.

According to state records, two certified nursing assistants immediately called Manning to Jacobs’ room, informing her Jacobs needed his airway suctioned. Manning allegedly took Jacobs’ vital signs and told an 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. Jacobs soon showed no signs of respiration, having died in his chair.

The 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 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.’”

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 Iowa Department of Inspections, Appeals and Licensing fined Fonda Specialty Care $10,000 for Jacobs’ death, then reduced that penalty 35%, to $6,500, due to the lack of an appeal in the case. Manning entered into a settlement agreement with the Iowa Board of Nursing in which she agreed to indefinitely suspend her practice of nursing.

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