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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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Houston icon George Foreman laid to rest in Iowa, drawn by a peaceful 1988 visit

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Houston icon George Foreman laid to rest in Iowa, drawn by a peaceful 1988 visit


The late boxing great George Foreman lies buried in a cemetery in the northwestern corner of Iowa – a place he has no connection to outside of a lone visit to the region nearly 40 years ago.

Foreman died March 21, 2025, at the age of 76 in Houston and was buried in Logan Park Cemetery at Sioux City, Iowa, a month later, city officials confirmed. Foreman’s family returned Thursday to his burial site, holding a news conference with Sioux City Mayor Bob Scott to reveal Foreman’s burial place, marked by a large monument that bears an image of him as a teen following his Olympic gold medal boxing win.

The family explained in a statement released by Sioux City officials that he had visited the Iowa city in 1988, and often recalled the sense of peace he experienced there.

After traveling to the city on April 17 last year to bury Foreman, his family said they immediately understood the region’s appeal.

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“Our father lived a life of purpose, faith and gratitude,” the family said in a statement released by Sioux City officials. “To see him laid to rest in a place that brought him peace means everything to us.”

Scott joined the family at Foreman’s monument that lies just a few miles north of the Missouri River in an upper Midwest city of nearly 87,000 people. The cemetery overlooks the scenic Loess Hills, created by windblown silt deposits that reach up to 200 feet high (about 61 meters) and line the river along the Iowa border for 200 miles (322 kilometers).

“Their story is a reminder of how one place can stay with someone for a lifetime,” Scott said.

A native Texan, Foreman rose to fame when he made the 1968 U.S. Olympic boxing team, winning gold in Mexico City. He became the heavyweight champion of the world in 1973 by defeating the great Joe Frazier, only to lose the title a year later to Muhammad Ali in the famous “Rumble in the Jungle.”

A full 20 years later in 1994, Foreman became the oldest man to win the heavyweight championship at 45, defeating Michael Moorer in an epic upset.

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Foreman retired in 1997 with a 76-5 career record.

He then moved on to the next chapter in his life as a businessman, pitchman and occasional actor, becoming known to a new generation as the face of the George Foreman Grill. The simple cooking machine sold more than 100 million units and brought him more wealth than boxing.

A biographical movie based on Foreman’s life was released in 2023.

Copyright © 2026 by The Associated Press. All Rights Reserved.



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GOP governor candidate Zach Lahn pitches Iowa-first platform at Dubuque town hall

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GOP governor candidate Zach Lahn pitches Iowa-first platform at Dubuque town hall


DUBUQUE, Iowa (KCRG) — About 50 Iowans braved the threat of severe storms to hear from Republican candidate for governor Zach Lahn at his town hall in Dubuque Friday night.

Lahn, a farmer and businessman, said his campaign is about solving the long-term systemic issues facing Iowans.

One priority is addressing what Lahn calls a cancer crisis in Iowa, as the state has the second-highest cancer rate in the country. Solving the crisis means ensuring Iowans have access to clean, nitrate-free drinking water, working with farmers to reduce agricultural runoff.

“Iowans are just ready for something that they should be able to count on, like clean drinking water,” Lahn said. “We have ways to clean up the drinking water in Iowa that isn’t on the backs of farmers, but is working alongside with them because they’re drinking the water too, and they want to do what’s right.”

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Lahn also wants to stop Iowa’s “brain drain,” as more of Iowa’s college graduates left the state for opportunities elsewhere.

“Don’t leave! Give me some time! I’m going to fight to keep you here,” Lahn said. “I was one of these kids. I thought I had to leave the state to find something better. We have to prioritize Iowa’s incentive dollars to make sure they’re going to grow Iowa businesses that are going to be here for the long haul, so our kids have places to work.”

Running a distinct campaign feels challenging this election, as Lahn is one of five GOP candidates who want to be Iowa’s next governor, facing U.S. Rep. Randy Feenstra, former Department of Administrative Services Director Adam Steen, state Rep. Eddie Andrews and former state Rep. Brad Sherman.

Iowa Auditor Rob Sand is the only Democrat running for the state’s top office.

Lahn said he stands out by promising Iowa will be for Iowans, pledging to ban the use of eminent domain for private gain and tax out-of-state landowners and data centers at higher rates to lower property taxes.

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“It always goes back to follow the money, so when it comes to not being a weak-kneed Republican today, I believe the paramount piece of that is answering only to the citizens of Iowa, not to special interests to pad their bottom line, but what’s best for the people of Iowa,” Lahn said.

Copyright 2026 KCRG. All rights reserved.



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Iowa State adds women’s wrestling, Alli St. John to coach

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Iowa State adds women’s wrestling, Alli St. John to coach


Iowa State announced Thursday the addition of women’s wrestling as its 18th varsity sport, with the program scheduled to begin competition during the 2027-28 academic year. The team is the first varsity sport added at the university since soccer in 1996. Iowa State will be the 12th school in the state of Iowa to have an NCAA women’s wrestling program.

The Cyclones will be only the second Power Four institution to feature a varsity women’s wrestling program, joining the University of Iowa.

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The university appointed Alli St. John, a two-time World Wrestling Championships silver medalist, as the program’s first head coach. St. John, who has spent the last three years with the Cyclone Regional Training Center, was a two-time women’s college national champion at King University.

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“I am incredibly honored and grateful for the opportunity to be the first head coach of women’s wrestling at Iowa State University,” St. John said. “This is a historic moment not only for Iowa State University, but for the sport of wrestling, too. Iowa State has a rich wrestling tradition, and I’m excited to expand that legacy on the women’s side as we work to build a premier program in Ames that produces not only NCAA champions, but World and Olympic champions as well.”

The program will support a roster of 30 student-athletes with 10 scholarship equivalents, matching the scholarship limit of the men’s team. Official competitions will be held in Hilton Coliseum, with practice facilities in Beyer Hall.

The university also announced a major restructuring of its wrestling leadership, naming long-time men’s head coach Kevin Dresser as the Director of Wrestling. In this new capacity, Dresser will oversee both programs, assisting with fundraising and mentoring the coaching staff, which includes newly promoted men’s head coach Brent Metcalf.

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“The addition of women’s wrestling is an exciting opportunity for Iowa State Athletics,” Dresser said. “The fact that it is one of the fastest growing sports at the high school level coupled with the overall love of wrestling in the state of Iowa makes this a very good decision. I can envision the Iowa Corn Cy-Hawk dual already and the excitement it will bring to the sport. I am excited to roll up my sleeves and help start another wrestling program.”

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