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New report details low staffing, high turnover in Iowa nursing homes

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New report details low staffing, high turnover in Iowa nursing homes


More than 43% of Iowa nursing homes do not meet upcoming federal mandates on staffing levels, a new national report shows.

The report also indicates 21 Iowa care facilities each cycled through three to five nursing home administrators during 2023.

Using newly published data collected by the federal government, a nonprofit advocacy group called the Long-Term Care Community Coalition has issued a detailed report outlining the staffing levels at every Medicare-certified nursing home in the nation during the fourth quarter of 2023.

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The report compares actual staffing levels with the Biden administration’s new rule mandating specific staffing levels in Medicare-certified nursing homes. That rule requires the presence of a registered nurse 24 hours per day, seven days a week in all facilities, as well as 3.48 hours per day, per resident of total nursing-staff time.

The rule will be phased in over the next five years and includes exemptions and waivers for facilities in rural areas that are making a good-faith effort to meet the new mandates.

The coalition’s report shows that 6 in every 10 U.S. nursing homes would have met the new nurse-staffing standard in the fourth quarter of 2023. Iowa homes fell below the national average, with 56.5% of them meeting the new standard.

The fact that a majority of facilities already meet the new minimum standard while still facing quality-of-care deficiencies has been an issue with many advocates, who say the standards don’t go far enough. They point to a federal study that shows each resident needs at least 4.1 hours of nursing care each day ― a standard met by only 26% of all nursing homes nationally and 24% of all homes in Iowa, according to the coalition’s report.

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The report indicates the Iowa homes with the lowest nurse staffing levels in the fourth quarter of 2023 were Arbor Springs of West Des Moines, Midlands Living Center of Council Bluffs, Linn Haven Rehab & Health Care of New Hampton, Pleasant Acres Care Center of Hull, Northbrook Healthcare and Rehabilitation Center of Cedar Rapids, Crest Haven Care Centre of Creston and Aspire of Perry. All reported less than 2.5 hours of total nursing care per resident, per day, according to the report.

A separate set of data published by the Centers for Medicare and Medicaid Services indicates that 14% of Iowa’s 422 nursing facilities were cited for insufficient staffing in fiscal year 2023. That’s more than double the national average, which was 5.9%.

Only five other states ― Hawaii, Michigan, Montana, New Mexico and Oregon ― had a worse record of compliance with the sufficient-staffing requirement. Iowa neighbors Nebraska, South Dakota, Wisconsin and Missouri had no more than 2% to 6.8% of their facilities cited for insufficient staffing in 2023.

Report pinpoints high turnover in some Iowa homes

The report also highlights a problem in many nursing homes nationwide: high staff turnover, which disrupts continuity of care and leads to errors by workers who aren’t familiar with residents’ needs.

According to the data, several Iowa homes had annual nurse staffing turnover rates of more than 85%, indicating that, on average, almost every nursing position in the facilities had been vacated and refilled in 2023.

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The Iowa homes with the highest rate of nursing-staff turnover, ranging from 85% to 100%, were Risen Son Christian Village of Council Bluffs, Sunrise Retirement Community of Sioux City, Wesley Acres of Des Moines, Arbor Springs of West Des Moines, Dunlap Specialty Care, Azria Health Park Place of Des Moines, Sunny Knoll Care Centre of Rockwell City and Montezuma Specialty Care.

The report also identifies the Iowa nursing homes that had the highest number of administrators who left employment with the facility during 2023.

The Elmwood Care Centre of Onawa and Heritage Specialty Care of Cedar Rapids are each reported to have had five administrators who left the facility in 2023. Azria Health Park Place of Des Moines, Sunny Knoll Care Centre of Rockwell City, Crest Haven Care Centre of Creston, Cedar Falls Health Care Center, Premier Estates of Muscatine, Westwood Specialty Care of Sioux City, Casa De Paz Health Care Center of Sioux City, Wesley Park Centre of Newton and Garden View Care Center of Shenandoah each are reported to have had four administrators leave during the year. Ten other Iowa nursing homes had three administrators leave during the year.

The coalition’s report shows that nationally, 4 of 5 nursing home residents live in facilities that are providing less than the federally recommended, but not mandated, 4.1 hours of total nursing-staff time per resident, per day. In addition, more than half a million nursing home residents live in facilities that don’t meet the new federal staffing requirement of 3.48 hours.

The report suggests one positive trend in nursing homes: a decreased reliance on temp-agency workers who often cost more but are less familiar with individual residents’ needs. After years of increased use of temp-agency workers during the COVID-19 pandemic, the use of such workers nationwide accounted for 8% of all nursing staff hours, which is down from 8.7% the previous quarter.

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In Iowa, the average percentage of temp-agency workers was 7.3% in the last quarter of 2023, which was down slightly from 7.6% the previous quarter, and down significantly from 10.2% the previous year.

Find this storyat Iowa Capital Dispatch, which is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Iowa Capital Dispatch maintains editorial independence. Contact Editor Kathie Obradovich for questions:kobradovich@iowacapitaldispatch.com.



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Iowa

New testing required for dairy cattle participating in Iowa fairs

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New testing required for dairy cattle participating in Iowa fairs


CEDAR RAPIDS, Iowa (KCRG) – On Tuesday, the Iowa Secretary of Agriculture announced new testing requirements for dairy cattle participating in Iowa fairs and exhibitions.

Secretary Mike Naig announced the new requirements as a way to minimize the potential spread of Highly Pathogenic Avian Influenza (HPAI). HPAI (also known as Bird Flu) has hit numerous dairy cattle in the state. The Secretary says the state should expect to see new positive cases announced as the increased testing takes place.

“The Department is issuing a statewide order effective July 1 that will require additional tests for HPAI prior to dairy cattle participating at our state’s many fairs and exhibitions,” said Secretary Naig. “We want to strike a balance between allowing our 4-H, FFA, and dairy exhibitors the opportunity to show their animals, while also requiring additional testing to protect our livestock and minimize the potential spread of the virus,” said Secretary Naig.

To date, the state has reported 11 positive cases of HPAI within dairy herds in Iowa. 9 of those cases have been detected in Sioux County. Iowa has had three poultry cases thus far in 2024, including one case in a commercial chicken layer in Sioux County and two cases in commercial turkey flocks.

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“Highly Pathogenic Avian Influenza isn’t just a poultry issue or a dairy issue, it’s an issue for all of agriculture. Our approach is reflective of our significant livestock industry, and I want to thank our farmers who have stepped up to help contribute to the broader understanding, visibility and knowledge of this virus,” said Secretary Naig. “We should expect additional challenges ahead and as the situation continues to evolve, we will also continue to evaluate our response. We continue to support our farmers through the joint state and federal response team who are navigating this evolving and unpredictable situation.”

Suspected signs of HPAI in poultry include:

  • Sudden increase in bird deaths without any clinical signs
  • Lethargy and/or lack of energy and appetite
  • Decrease in egg production
  • Soft, thin-shelled and/or misshapen eggs
  • Swelling of the head, eyelids, comb, wattles, and hocks
  • Purple/blue discoloration of the wattles, comb, and legs
  • Difficulty breathing
  • Coughing, sneezing, and/or nasal discharge (runny nose)
  • Stumbling and/or falling down
  • Diarrhea

Suspected signs of HPAI in dairy cows include:

  • Decrease in food consumption with a simultaneous decrease in rumination
  • Clear nasal discharge
  • Drop in milk production
  • Tacky or loose feces
  • Lethargy
  • Dehydration
  • Fever
  • Thicker, concentrated, colostrum-like milk

Officials say that it is safe to enjoy poultry products. Consumers should utilize the proper handling and cooking of eggs and poultry products, including cooking to an internal temperature of 165˚F.

There is no concern about the safety of pasteurized milk or dairy products. Pasteurization has continually proven to successfully inactivate bacteria and viruses, like influenza, in milk.

If dairy producers suspect cases of HPAI, they should contact their herd veterinarian immediately. Possible cases must also be reported to the Iowa Department of Agriculture and Land Stewardship at (515) 281-5305.

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2024 Eastern Iowa fireworks displays

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2024 Eastern Iowa fireworks displays


CEDAR RAPIDS, Iowa – Cities across Iowa are preparing to host annual Independence Day fireworks displays!

Here is a list of displays you can see in eastern Iowa this year:

Bettendorf

  • Parade at 10 a.m. on July 4 in downtown Bettendorf
  • 4th of July Festival from noon to 10 p.m. on Spruce Hills Drive in front of Cumberland Square
  • Fireworks at Middle Park at dusk
  • More info

Cedar Falls

  • Fireworks Over the Dome at 9:40 p.m. on June 27

Cedar Rapids

  • Ellis Fireworks on the River at 9 p.m. on July 3 – more info
  • Cedar Rapids Freedom Festival – Celebration of Freedom Fireworks
  • Fireworks start at dark on July 4 in downtown Cedar Rapids
  • More info

Charles City

  • Fourth of July Celebration from July 3-6
  • Fourth of July Parade begins at 11 a.m. on July 4, then fireworks by the Cedar River in the evening
  • Main Street Charles City’s Party in the Park on July 5
  • July 6 – magician show, cornhole tournament
  • More info

Coralville

  • Coralville’s annual 4thFest parade at 10 a.m. on July 4, starting and ending at the corner of 9th Street and 22nd Avenue
  • Fireworks display in S.T. Morrison Park at dark, around 9:45 p.m.

Garnavillo

  • Festivities from July 3-4, more info here
  • Parade at 10 a.m.
  • Fireworks display at dusk

Independence

  • Celebrate Indee July 3-4 at Riverwalk Parks
  • July 4 – festivities begin in Riverwalk Parks at 10:45 a.m.
  • Fireworks over the Wapsipinicon River at 10 p.m. on July 4
  • More info

Marion

  • Marion’s 5th annual Fireworks & Fireflies celebration on July 3 at Klopfenstein Amphitheater at Lowe Park, starting at 6 p.m.
  • More info

Mechanicsville

  • Fireworks at dusk on 125th Street at dusk
  • More info

Muscatine

  • Kids Parade (Pearl Plaza to Musser Public Library) at 9 a.m.
  • Community parade in downtown Muscatine at 4 p.m.
  • Almost Fireworks Fest on the Riverfront, 5 p.m. to 8 p.m.
  • Muscatine Symphony Orchestra at 8:10 p.m.
  • Fireworks at dusk
  • More info

North Liberty

  • Fireworks display at 9:30 p.m. on July 3 in Penn Meadows Park
  • More info

Oxford Junction

  • 4th of July Parade starts at 4 p.m. at Midland Elementary School, ends at Wapsi Park
  • Fireworks display at dusk at Wapsi Park
  • More info

Tama/Toledo

  • Annual fireworks display at dusk on July 4 at the Toledo Heights Park
  • More info

Tipton

  • 4th of July Parade at 11 a.m.
  • Fireworks at dusk at the Cedar County Fairgrounds
  • More info

Washington

  • 4th of July fireworks display at 9:15 p.m. at the Washington County Fairgrounds
  • More info

Waterloo

  • Waterloo’s annual fireworks event from 6 p.m. to 11 p.m. on July 6, along the Cedar River downtown.
  • Fireworks begin at 10 p.m. on July 6

Wellman

  • North Park activities begin at 4 p.m. on July 4
  • Fireworks at dusk

Know of other communities holding fireworks displays? Send us the information at newsroom@kcrg.com.

Share your 4th of July celebration photos with us:

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‘It’s so much more than embarrassment’: Eastern Iowa Tourette Syndrome activists call for education, kindness

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‘It’s so much more than embarrassment’: Eastern Iowa Tourette Syndrome activists call for education, kindness


CEDAR RAPIDS, Iowa (KCRG) – A semi-retired doctor and his wife are helping patients navigate Tourette Syndrome.

Tourette Syndrome is characterized by tics. These are compulsive movements or sounds people can’t control. Less than 1% of the population has the condition.

Dr. Scott Nau thought he knew about Tourette Syndrome from his medical training. However, he said his real “degree” in the field came from his marriage to Jackie, who has Tourette’s.

Jackie said having Tourette is “so much more than embarrassment and humiliation,” although she added those definitely “rank way up there”.

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“I spent a year and half of my life grabbing my crotch, and there’s no way you can put a shine on that, especially for a woman,” she said. “That’s while I had a great career of cutting hair, and it makes you feel undignified no matter where I go.”

Obscene gestures and unusual sounds are embarrassing, but Jackie said what people don’t understand is that Tourette Syndrome is also anxiety and physical pain. After a lifetime of head and neck tics, Jackie had significant arthritis issues in her neck and got neck surgery a few months ago.

“I got a tiny scar there, and that was pretty brutal to go through that, and to know that it came from this disorder that I’d give anything not to have.”

Jackie said the pain and the embarrassment were made all the worse by the fact she didn’t know anyone else like her until her forties.

“When I mostly retired a couple of years ago, I realized that my patients who did have Tourette Syndrome really didn’t have the support that they need,” said Dr. Scott Nau, Jackie’s husband. “And so we decided to team up.”

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With a parent’s permission, Jackie will sit in on meeting with doctor and patient. The couple goes out to lunch with patients, and they will even go to kids’ schools and explain Tourette Syndrome to their classmates and teachers.

“Oftentimes, peers become warriors for their friends if they know what’s going on,” said Scott.

Two patients the Naus have worked with are Rachel Peters from North Liberty and Torrie Davis from Cedar Rapids.

Davis was diagnosed in 2022, and Peters not until a couple of months ago.

“I will go to the bathroom and have to cry out of embarrassment because, you know, it’s very—it’s very hard,” said Peters.

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Both girls said the help from the Naus has been literally life changing.

“Jackie is like a second mom,” said Davis. “She’s a role model.”

Jackie herself wishes for friendship like these girls have—someone else with Tourette Syndrome who can truly understand.

“I long for a female adult friend in my orbit,” she said.

Still, she’s determined to help younger generations avoid the isolation or the shame she has known.

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“I know that I was born this way for a reason, and God has entrusted me to get the message out.”

Patients do not need a referral to see Dr. Nau about existing or suspected Tourette’s syndrome. Call Mercy Pediatric Clinic at (319) 861-7900 to make an appointment. He can usually see them within a few days.



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