Iowa is expected to spend more than $9 million to place 100 out-of-state nurses and respiratory therapists at the state’s larger health care facilities for six weeks of the latest spike of COVID-19 hospitalizations.

The state agreed early this month to pay a Kansas company $220 per hour for the nurses it supplies, with the expectation that the nurses will work 20 hours of overtime each week at the rate of $330 per hour, said Sarah Ekstrand, an Iowa Department of Public Health spokesperson.

That equals more than $15,000 per week per nurse the state will pay Favorite Healthcare Staffing, of Overland Park, Kansas. The company acts as a go-between that solicits freelance nurses for hospitals. The company pays the nurses and provides housing for them, most often at hotels, according to recent job listings.

Iowa inked a contract with the company in July 2020 at lower pay rates of between $71 and $160 per hour with the caveat that “rates are subject to change with a written notice,” according to that contract. The state did not acquire supplemental nurses at that time because hospitalizations were relatively low.

But by mid-November that year, the number of people infected by the coronavirus who required inpatient treatment at hospitals had tripled over the course of a month and peaked at more than 1,500.

That number of hospitalizations had declined by about a third by the time the state acquired nurses from Favorite Healthcare starting Dec. 4, 2020, state data show. The company provided 100 nurses for most of December 2020 and January 2021, Ekstrand said, and 68 of those nurses also worked the first week of February.

The average number of hospitalizations in January was lower than the recent months of September, October and November.

“The height of the surge occurred in mid-November, however, that was not apparent at the time the staffing was initiated,” Ekstrand said of the 2020 hospitalization peak, “and regardless, hospitals welcomed the relief/support.”

The total bill for the supplemental nurses during that period was about $6.9 million, Ekstrand said. The state paid for the nurses with “federal funding,” she said, but she declined to specifically cite the funding source.

Higher rates a year later

The coronavirus pandemic continues to stretch thin a diminished supply of nurses. Last year, the state’s first-ever Iowa Nursing Demand Survey revealed that “finding qualified candidates” was the most commonly reported workforce challenge for those who employ nurses.

Jennifer Nutt, of the Iowa Hospital Association, has said “hospitals are in a staffing crisis.” That has driven up the cost of finding temporary help.

“The current rates reflect the necessary rate at this point in time to rapidly recruit and place qualified staff,” Ekstrand said.

The out-of-state nurses arrived in Iowa this month and started work as early as Dec. 7, she said. The 17 facilities that provide higher levels of care that received the temporary help are:

– Genesis Medical Center, in Davenport: 10

– UnityPoint Health-Iowa Methodist Medical Center, in Des Moines: 10

– University of Iowa Hospitals and Clinics, in Iowa City: 10

– MercyOne Des Moines Medical Center, in Des Moines: 8

– MercyOne North Iowa Medical Center, in Mason City: 7

– St. Luke’s Methodist Hospital, in Cedar Rapids: 7

– Mercy Medical Center, in Cedar Rapids: 6

– MercyOne Dubuque Medical Center, in Dubuque: 6

– UnityPoint Health-Allen Memorial Hospital, in Waterloo: 6

– Jennie Edmundson Memorial Hospital, in Council Bluffs: 5

– UnityPoint Health Finley Hospital, in Dubuque: 5

– CHI Health Mercy Council Bluffs, in Council Bluffs: 4

– Mary Greeley Medical Center, in Ames: 4

– MercyOne Waterloo Medical Center, in Waterloo: 4

– MercyOne Siouxland Medical Center, in Sioux City: 3

– St. Luke’s Regional Medical Center, in Sioux City: 3

– Mercy Iowa City, in Iowa City: 2

Ekstrand has said the additional staffing helps rural hospitals as well because they should have more opportunities to transfer seriously ill patients to the larger hospitals.

The state is paying $220 per regular hour and $330 per overtime hour to Favorite Healthcare for each supplemental nurse. The company has been recruiting nurses for the temporary jobs in Iowa at rates of $110 to $125 per regular hour and $165 to $187.50 per overtime hour, according to recent online job postings.

Favorite Healthcare also provides hotel stays for the nurses and an unspecified transportation bonus.

The company is also soliciting dozens of nurses to work in California, Illinois and Oregon. In a May press release, the company said it had expanded significantly during the pandemic and had “mobilized more than 16,000 healthcare professionals across the country.” The company’s travel nursing division grew 1000% in the first three months of 2021, the company reported, and it planned to build a new corporate headquarters.

“At Favorite, we pride ourselves in creating jobs and providing qualified and dependable talent whenever, wherever needed,” Chris Brink, president of Favorite Healthcare Staffing, said in the press release. “Over the past year, we have been challenged to be more responsive than ever. Our technological innovations have allowed us to increase our speed to hire and fill critical positions on a national level.”

On Wednesday, the number of COVID patients in Iowa hospitals had fallen 11% from a recent peak for the year last week. There were 747 receiving impatient treatment, and 158 were under intensive care.

Ekstrand said unspecified federal funding will also pay for the current group of supplemental nurses, which was expected to total at least $9.24 million.

Iowa Capital Dispatch 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: info@iowacapitaldispatch.com. Follow Iowa Capital Dispatch on Facebook and Twitter.

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