One of Iowa’s s largest nursing home operators is facing the 10th wrongful death lawsuit filed against the company this year.

Recently, the family of the late Debbie Thomas sued Care Initiatives of West Des Moines and the Appanoose County nursing home the company operates, Centerville Specialty Care, in state court. The family is seeking unspecified damages for professional negligence, wrongful death and dependent adult abuse.

Care Initiatives, which doesn’t comment on pending litigation, has yet to file a response to the lawsuit. So far this year, at least 10 wrongful death lawsuits have been filed against company, which operates 43 Iowa nursing homes as well as several assisted living centers and hospice locations. In each of the lawsuits, Care Initiatives has denied any wrongdoing. Roughly 2,800 elderly or disabled Iowans receive care from one of the company’s facilities.

In August, the Iowa Capital Dispatch reported Care Initiatives was facing at least 10 then-active lawsuits, some of which were filed in 2023, alleging negligence or wrongful death. Some of those cases have since been resolved, but additional cases have been filed in the past three months.

One of the new cases involves Thomas, an Appanoose County woman who had sustained brain damage at birth in 1958. As an adult, Thomas could read, write and socialize with others and lived an active adult life, according to court records.

State inspection reports indicate that on Dec. 19, 2022, at the age of 64, Thomas was admitted to Centerville Specialty Care for rehabilitation after a brief hospital stay. According to the recently filed lawsuit, Thomas was joined by family members for dinner at the care facility two days after her admission, at which point the relatives found second-degree burns covering Thomas’ legs.

The family alleges Thomas’ bed had been pushed against a wall near a heating element. According to the lawsuit, the staff at Centerville Specialty Care was unaware of the burns until the family discovered them.

The next day, relatives returned to the home and allegedly discovered Thomas had developed a bed sore that the home’s staff characterized as “minor” – although, the lawsuit claims, the staff refused to say whether the wound was infected.

By Jan. 7, Thomas was allegedly diagnosed as malnourished and dehydrated, and on Jan. 27, the staff allegedly found that her blood pressure had dropped to an extremely low level. On Jan. 29, staff at the home called Thomas’ family to inform them Thomas was in a state of decline and was dying, according to the lawsuit.

“Nobody at Centerville Specialty Care called a doctor or an ambulance for Debbie until (her sister) demanded they do so,” the lawsuit claims.

Thomas was rushed to the emergency room at MercyOne-Centerville, where the medical staff allegedly concluded she was severely dehydrated, had a urinary tract infection, her kidneys were failing, and she had potassium levels so low they could trigger a heart attack. According to the lawsuit, doctors then showed the family a bed sore Thomas had sustained and which measured roughly 4 inches across.

Thomas died on Feb. 1, 2023. State records indicate the cause of death was sepsis – an often-deadly infection – that resulted from a bed sore.

Five days later, the Iowa Department of Inspections, Appeals and Licensing initiated an investigation at the Centerville home in response to seven complaints. Four of the complaints were substantiated, according to DIAL records.

The inspectors reported that the hospital’s emergency room physician said that when Thomas arrived there from Centerville Specialty Care, she was in serious pain and was admitted in critical condition with a deep, open, “grapefruit sized” bed sore that had become infected. The physician allegedly described Thomas’ hair as “matted, very dirty and unkempt” when she arrived in the ER.

State inspectors also reported that the physician questioned the accuracy of the nursing home’s claim that Thomas had been up and about and eating breakfast just hours before her admission to the ER.

The state proposed a $9,750 state fine that was then held in suspension while the Centers for Medicare and Medicaid Services considered a federal fine. CMS records indicate the agency eventually imposed a fine of $56,750 against the Centerville home.