Cognizant of the potential liability arising out of the COVID-19 pandemic, the Iowa General Assembly passed the “COVID-19 Response and Back-to-Business Limited Liability Act.” 2020 Iowa Acts ch. 1070, §§ 3–10 (codified at Iowa Code chapter 686D (2021)). Among other things, the Act provides that, with respect to COVID-19-related injuries or death, “[a] health care provider shall not be liable for civil damages for causing or contributing, directly or indirectly, to the death or injury of an individual as a result of the health care provider’s acts or omissions while providing or arranging health care.” Iowa Code § 686D.6(1) (2022). The Act contains an exception: it does not relieve a health care provider for liability “for any act or omission which constitutes recklessness or willful misconduct.” Id. § 686D.6(2).
The plaintiffs sued a health care provider for wrongful death, alleging the health care provider’s reckless and willful failure to comply with certain federally recommended practices related to COVID-19 prevention resulted in the death of a resident in the provider’s skilled nursing facility. The district court dismissed the suit on the defendant’s motion for summary judgment, holding the plaintiffs failed to establish reckless or willful misconduct as a matter of law. The plaintiffs appealed.
Underlying Facts
In March 2020, federal and state authorities declared a public health emergency in response to the COVID-19 pandemic. In June of 2020, the nursing home resident (“Rose”) was removed from the facility and hospitalized for a medical condition. On June 24, Rose was released from the hospital and returned to the facility (Oakland Manor). Oakland Manor placed Rose in precautionary isolation for fourteen days in accordance with public health guidance to prevent the spread of COVID-19.
Rose tested negative for COVID-19 on July 7 and 10. On July 10 and 13, Rose had two off-site medical appointments. The off-site medical appointments caused the facility to place Rose in precautionary isolation for another fourteen-day period. The second period of precautionary isolation was cut short when Rose was hospitalized for a suspected stroke on July 23. He tested positive for COVID-19 on the day he was admitted to the hospital. Rose died at the hospital on August 1. The death certificate listed Rose’s immediate cause of death as COVID-19 infection due to acute hypoxic respiratory failure and bacterial pneumonia. The death certificate listed other significant medical conditions, including bacteremia, lactic acidosis, obesity, and diabetes.
In August and September of 2020, the Iowa Department of Inspection and Appeals conducted a COVID-19 Focused Infection Control Survey at Oakland Manor and an investigation of certain complaints related to Oakland Manor’s
response to COVID-19. Based on that survey and investigation, the Centers for Medicare and Medicaid Services (CMS) issued a Statement of Deficiencies to Oakland Manor in September (“CMS Report”). The CMS Report identified certain inadequacies in Oakland Manor’s practices related to a variety of things, such as recordkeeping, confidentiality of private information, and COVID-19 prevention. With respect to the last item, the CMS Report identified deficiencies such as improper sanitization of the sit-to-stand lift, the failure to complete hand hygiene, the failure to wear complete personal protective equipment (PPE), and the failure to completely seal an isolation area. The CMS Report noted that thirty of the thirty-one residents at the facility had tested positive for COVID-19 during the course of the pandemic. The CMS Report “identified that the facility was not in compliance with CMS and Centers for Disease Control and Prevention (‘CDC’) recommended practices to prepare for COVID-19.”
The only evidence the plaintiffs put in the record in support of their resistance to Oakland Manor’s motion for summary judgment based on immunity was the CMS Report and their expert witness disclosure. The district court granted Oakland Manor’s motion for summary judgment and dismissed the case. The district court explained that the statutory immunity provided that a health care provider could not be liable for civil damages while providing or arranging care.
The Iowa Supreme Court held in its January 23, 2026 Opinion: “The deficiencies identified in the CMS Report, whether considered together or in isolation, reflect the lack of adherence to recommended protocols—failures of execution or consistency—rather than intentional acts done with conscious disregard of a known or obvious risk. These are the very type of shortcomings for which the legislature eliminated civil liability as a matter of public policy … [plaintiff’s expert] Mincer offered only a conclusory opinion. Mincer conducted no independent factual investigation. She reviewed only the CMS Report and the death certificate. Her resulting opinion lacked any factual detail regarding Oakland Manor’s conduct, and it lacked any analysis supporting an inference that Oakland Manor’s conduct was intentional rather
than merely negligent. This type of conclusory expert opinion is insufficient to create a genuine issue of disputed fact supporting an inference of recklessness … we conclude the district court did not err in granting the defendant’s motion for summary judgment. Because we conclude that the plaintiffs failed to establish recklessness as a matter of law, we need not address the issue of causation, and we vacate the court of appeals opinion regarding causation.”
Source Rose v. Oakland Healthcare Management, LLC, d/b/a Oakland Manor, No. 23–1788.
If you or a loved one suffered a serious injury (or worse) as a result of medical negligence in Iowa or in another U.S. state, you should promptly find an Iowa medical malpractice lawyer, or a medical malpractice in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
Click on the “Contact Us Now” tab to the right, visit our website, or call us toll-free in the United States at 800-295-3959 to find medical malpractice attorneys in your state who may assist you.
Turn to us when you don’t know where to turn.
