Iowa paying $9 million for extra nursing staffing

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.

The Gazette reported earlier this month that the state was hiring the 100 extra people, including how many would be deployed to hospitals in Cedar Rapids, but at the time details of the full contract were not yet available.

The contract equals over $15,000 per week per nurse the state will pay Favorite Healthcare Staffing, of Overland Park, Kan. 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.

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.

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

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.