She was told to keep her mouth shut. She didn’t.

John and Terri Hale

In a column published in May 2025, we wrote about the allegations contained in a lawsuit filed by a former certified nurse aide at a nursing home in Fonda. The suit was filed against the Fonda Specialty Care nursing home, its parent company, Care Initiatives, and a licensed practical nurse working at the facility.

The suit alleged this: A certified nurse aide saw an 87-year-old resident of the facility with a tracheostomy struggling to breathe. The aide sought the help of the nurse on duty to suction the airway. The nurse refused to do so, even after multiple requests from staff members. The aide attempted to contact off-site management staff but could reach no one. She sought permission to call 911 and was rebuffed. The resident died in a way that the lawsuit describes as “agonizing and painful.”

The suit went on to allege that after the certified nurse aide’s shift was over, the aide received multiple text messages from the facility administrator to “Keep your mouth shut and keep your opinions to yourself” along with instructions to not communicate with the deceased resident’s family. The next day, the aide was fired due to “resident complaints.”

The nursing home aide did not keep her mouth shut. She decided to blow the whistle and fight her dismissal. She found attorney Molly Hamilton of West Des Moines to assist her. The lawsuit filed was recently settled out of court with a confidentiality provision, meaning that no one could talk about what the settlement included.

So, Fonda Specialty Care and Care Initiatives — those who initially told the nursing home aide to keep her mouth shut and to keep her opinions to herself — ended up getting what they wanted: silence. No one can talk about what the settlement included. No one can say what if any compensation was received by the certified nurse aide and her attorney. No one can give an opinion on anything involving the case. The public will never know all it should know about what happened, how and why.

What we do know is this: according to a recent Iowa Capital Dispatch article, the Iowa Department of Inspections, Appeals and Licensing fined Fonda Specialty Care $10,000 for “failing to ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care.”  The $10,000 fine was later reduced to $6,500 due to the lack of an appeal by the care facility.

This case, the settlement and the fine imposed by the State of Iowa raises all kinds of questions and concerns:

• Taxpayers pay for the bulk of nursing home residents’ care through Medicaid and Medicare. Don’t they have a right to know the details of tragic deaths occurring in nursing homes? Should confidential settlements be allowed?
• How can the public make an informed decision in choosing a nursing home for a loved one if they don’t know the details of lawsuits involving facilities they may be considering?
• How many more cases are there like the Fonda case where horrible things happen yet remain hidden from the public?
• Is $6,500 a big enough fine? Is that what the life of an 87-year-old is worth in the eyes of the State of Iowa?
• Does a $6,500 fine prevent similar tragedies happening in the future? If it doesn’t change the policies and practices of a nursing facility, what’s the point of levying a fine?

No resident of a nursing home should die a tortured death because their needs were neglected.  No employee of a nursing home should be asked to cover up the facts of the death. No society should tolerate abysmal treatment of nursing home residents or employees, yet ours does.

It is infuriating, pathetic and has gone on far too long.

It won’t change until voters elect those who pledge to change it.

John and Terri Hale own The Hale Group, an Ankeny-based advocacy firm focused on older Iowans, Iowans with disabilities, and the caregivers who support them. Email terriandjohnhale@gmail.com.