Iowa nursing home operator faces more wrongful death claims

(Des Moines) 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.

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 poor 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:

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.

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.

(Iowa Capital Dispatch Photo via Google Earth; document courtesy of Iowa District Court for Black Hawk County)