Murder charge in assisted-living case sparks questions from advocates

Advocates for Iowa seniors and caregivers are questioning a prosecutor’s decision to charge an assisted-living worker with murder in the death of an elderly resident.

Catherine Forkpa, 31, is charged with second-degree murder in the death of 77-year-old Lynne Stewart at the Courtyard Estates at Hawthorne Crossing, an assisted living center in Bondurant. The charge carries a penalty of up to 50 years in prison.

Stewart was one of two Iowa women who froze to death outside assisted living centers last winter. The other death, which took place in Spirit Lake, has not resulted in criminal charges.

“My heart goes out to the families of these women who died in such tragic ways,” said Di Findley, executive director of the Iowa CareGivers Association. “It raises numerous questions — like, is assisted living the proper level of care for people with dementia? Why would this case result in a murder charge when other cases have not? Is the direct care worker solely responsible?”

John Hale, a consultant and advocate for older Iowans, said that too often malfunctioning safety devices and alarm systems, inadequate notification systems and a lack of training are contributing factors in deaths and injuries in care facilities.

“When those additional factors exist, the responsibility for tragedies goes beyond the direct care staff on duty – it also goes to supervisory staff, facility management, facility owners and corporate directors,” he said.

State records indicate Stewart walked out of Courtyard Estates at about 9:40 p.m. on Jan. 21, triggering an alarm. By that time, a separate alarm attached to the door of Stewart’s room had already been tripped. The two alarms triggered a series of alerts that appeared on a desktop computer at the facility and on portable iPads carried by each of the workers.

According to police, surveillance video at the facility shows Forkpa walking around the facility for hours without checking on Stewart or resetting the alarm system.

At 6:10 a.m. the next day, a worker who had been assigned to another area of the building saw the door-alarm alerts, alerted Forkpa, and the two located Stewart outside, on the ground, with her parts of her body covered in ice. Stewart was pronounced dead at a nearby hospital.

Forkpa, who had worked at Courtyard Estates for seven months, was fired and four other employees were given written warnings for their failure to respond to door alarms, according to state records.

State records indicate several factors outside of Forkpa’s control may have contributed to Stewart’s death:

— Alarm defects: The alarm on Stewart’s door was known to malfunction and had not been repaired. As a result, it had been sending out false alerts to the staff, causing them to ignore the alarm, for at least a month. “All staff knew the door alarm failed to work properly and the issue was discussed at team meetings,” state inspectors later reported.

— iPad shortage: The facility may have had an insufficient supply of the iPads that workers carried to receive alerts from door alarms. The devices would usually function for a full shift, but by the time the next shift came on duty, the batteries would be depleted and so the devices had to be connected to a charging station. “Four iPads were available when fully charged, and only two chargers worked currently,” inspectors reported.  “The director was aware and new iPads were ordered a while ago.”

— Training: By law, Forkpa was supposed to have received at least 8 hours of dementia training in her first 30 days on the job. The home’s records suggested she had received no more than 4.75 hours of training in that time, inspectors alleged.

— Director alerted: The facility’s executive director told inspectors that the night Stewart died, she received text-message alerts on her phone that were triggered by the two door alarms, but she didn’t hear them as she slept. Inspectors said the first alert appeared on the director’s phone at 9:44 p.m., and they continued to be received every five minutes throughout the night.

— Nurse alerted: The facility’s on-call registered nurse received a similar series of alerts on her phone. She allegedly told inspectors she had noticed them, but failed to respond because she was at home with her family, and because she went to bed around 9:30 p.m.

— Nurse’s duties: The nurse told inspectors there was no expectation for her to respond to door-alarm alerts during on-call status, and that she was only expected to respond to phone calls from the on-duty staff. Inspectors reported that the nurse said she “should have called the staff to check on things but assumed the staff would take care of it.”

The state fined Courtyard Estates $10,000 and cited it for having failed to give Forkpa the required dementia training. Courtyard Estates acknowledged the problem and later reported to the state that the training issue was corrected by having Forkpa fired.

Forkpa, who immigrated to the United States from Africa in 2004, told the Iowa Capital Dispatch she doesn’t believe the murder charge is warranted. “I know in my heart I would never do anything to hurt anyone,” she said.

Polk County Attorney John Sarcone has declined to comment on the case. A trial is scheduled for Nov. 14.

Stewart froze to death just six weeks after 95-year-old Elaine Creasey froze to death outside Keelson Harbour, an assisted living center in Spirit Lake. In that case, the registered nurse accused of failing to properly perform the prescribed hourly checks on Creasey faces no criminal charges and has retained her nursing license.

In the Bondurant case, Findley wonders why Courtyard Estate’s administration isn’t held accountable for failing to respond to their phone alerts or seeing to it that the staff received the required training.

“The state must invest in lasting systemic changes that ensure a well-prepared direct-care workforce and the prevention of such needless deaths,” she said. “But really — take a moment to imagine freezing to death or suffering the loss of a loved one who froze to death under these circumstances. The human pain is too often forgotten or lost in the debate about who to blame.”

Hale says Iowa’s policymakers should consider their own actions in the wake of the two deaths.

“I wonder how the public and elected officials would respond if these tragedies involved kids in day care, versus older Iowans in nursing homes,” he said. “Would the response be different? Would the public care more, would legislators take action? Sadly, I think the answer is yes. There would be an outcry if these were kids. When bad things happen to older folks, the reaction is too often one of indifference.”