Family Practice Clinic Receives Patient Experience Award

clinic staff

Manning Regional Healthcare Center is proud to announce that their Family Practice Clinic has received The Guardian of Excellence-Patient Experience Award. This award honors healthcare facilities who have consistently reached the top (95th to 99th percentile) of their respective database for patient experience, employee engagement, physician engagement, consumer experience, or clinical quality performance.

“It is an honor to receive the Guardian of Excellence for Patient Experience Award from Press Ganey,” said MRHC Clinic Director, Shelby Dickson, RN. “Our team works hard to provide exceptional care by going above and beyond for our patients. They truly love what they do and who they work with.”

MRHC’s Family Practice Clinic is staffed by four providers, Dr. Douglas McLaws, DO; Dr. Thang Luong, MD; Courtney Rupiper, PA-C; and Sara Powers, ARNP; Clinic Director Shelby Dickson, RN; Health Coach, Amber Croghan; clinic nurses, Katelyn Namanny; Amanda Blum; Casey Quandt; and Roxi Doyel; medical records, Sharon Odendahl; and scheduler, Janey Stoelk.

Clinic staff were recognized for their dedication and hard work and presented with the award on Friday, February 16th with a hospital-wide reception.

The clinic offers extended hours Monday through Thursday 7am-6:30pm and Friday 7am-5pm and Saturday morning 8am-10am to accommodate busy schedules. Same day appointments for minor injuries or illnesses are also available for minor injuries and illnesses. Appointments can be made by calling (712) 655-8100.

clinic staff

Is it a cold, the flu or COVID? How to Combat Seasonal Illnesses

seasonal illness

While many people may think seasonal illnesses are worse around the holidays, flu season actually peaks in February. Since we are not quite in the clear yet, here is some important information from Manning Regional Healthcare Center (MRHC) to educate you about and prepare you for seasonal illnesses as well as some tips to help prevent illness.

According to MRHC Infection Preventionist, Jill Arp, influenza numbers are continuing at a steady pace. Common symptoms of the flu usually come on suddenly and include some or all of the following:

  • Fever or feeling feverish/chills are common and typically last three to four days
  • Aches are common and often severe
  • Chest discomfort and cough are common and can be severe
  • Sneezing, sore throat, and runny or stuffy nose can sometimes occur
  • Muscle or body aches are common and can be severe
  • Headaches are common
  • Fatigue and weakness are common
  • Some people experience vomiting and diarrhea, but it is more common in children than adults

“To help protect yourself, it isn’t too late to get your flu shot,” says Arp, RN, BSN. “Doses are available at MRHC until the end of March, we just ask that you call ahead so we can be prepared.”

Complications from the flu are possible and can range in severity. According to the CDC, moderate complications can include sinus and ear infections, while serious complications such as pneumonia can result from either the flu virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications can include inflammation of the heart, brain, or muscle tissues and multi-organ failure, including respiratory and kidney failure. Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis.

The flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic heart disease may experience a worsening of this condition.

People at Higher Risk from Flu

Anyone can get sick with the flu, but some people are at higher risk of developing serious flu-related complications if they get sick. Those 65 years and older, people with certain chronic medical conditions (asthma, diabetes, or heart disease), pregnant women, and children younger than five years old are at the highest risk, according to the CDC.

Warning Signs for Flu Complications in Children

When we’re sick, it can be difficult to know when a visit to the doctor is necessary, especially if it’s a child. Be aware of these warning signs and if your child displays any of the following, seek medical attention as soon as possible:

  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for eight hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104 degrees that is not controlled by fever-reducing medicine or any fever in children younger than 12 weeks
  • Fever or cough that improves but returns or worsens
  • Worsening of chronic medical conditions
Warning Signs for Flu Complications in Adults
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, and inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improves but returns or worsens
  • Worsening of chronic medical conditions

“It’s important to remember that if you or your child has a chronic health condition, are experiencing a persistent high fever, shortness of breath, chest pain, or the inability to keep any food or fluids down, it is more important to see your doctor sooner rather than letting it run its course,” advised Arp.

Common Cold Vs Flu or COVID-19

Especially at the beginning of an illness, it can hard to tell whether it’s just a common cold, the flu, or COVID. Here are some key differences to look for.

Common Cold Symptoms
  • Symptom onset is gradual
  • Fevers and headache are rare
  • Slight aches are possible
  • Chills are uncommon
  • Sometimes people experience fatigue and weakness
  • Sneezing is common
  • Mild to moderate chest discomfort and hacking cough
  • Stuffy nose and sore throat are common
COVID symptoms
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If you or a loved one test positive for COVID-19, it is important to watch for these emergency warning signs and seek medical attention if these symptoms are present:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
People at Higher Risk from COVID-19

While anyone is at risk of getting COVID, older adults, people with certain underlying medical conditions (including infants and children), and people who are pregnant are at higher risk.

Like the flu, COVID-19 can also lead to a variety of health complications including:

  • Pneumonia
  • Respiratory failure or acute respiratory distress syndrome (fluid in the lungs)
  • Sepsis
  • Cardiac injury (for example, heart attacks and stroke)
  • Multiple-organ failure (respiratory failure, kidney failure, shock)
  • Worsening of chronic medical conditions (involving the lungs, heart, or nervous system or diabetes)
  • Inflammation of the heart, brain, or muscle tissues
  • Secondary infections (bacterial or fungal infections that can occur in people with flu or COVID-19)

“To help protect yourself and others from sickness this winter, wash your hands often, get your immunizations, get enough sleep/rest, eat healthy, drink plenty of fluids, and stay away from those who are not feeling well,” shares Arp.

If you are not feeling well, MRHC offers convenient clinic hours and same-day appointments for minor illnesses. Call (712) 655-8100 to schedule an appointment.




Vitito Thrives as Nurse Practitioner at MRHC

Sara Vitito

Sara VititoManning Regional Healthcare Center’s Family Practice Clinic provider, Sara Vitito, ARNP, knew she wanted to work in healthcare for as long as she can remember. When a position became available at MRHC, Vitito jumped at the opportunity to practice in the community she lives in.

“My mom is a nurse practitioner and inspired me to be the provider I am today,” Vitito shared. “Practicing close to home gives me the ability to care for those in the community and establish relationships. And MRHC provides a sense of community. Patients are not just a number here; they are our friends, family, and neighbors.”

After receiving her BSN from the University of Nebraska Medical Center (UNMC) in 2017, Vitito worked as a nurse with CHI-Lakeside, caring for patients in an inpatient setting and ER. She went back to school for her DNP in 2018 at UNMC. During graduate school, Vitito worked at Methodist Health Systems as an ER nurse. When she finished her Doctorate in Family Practice in May 2021, she then took a position at CHI- Bergan as an ER provider. Vitito joined the MRHC team in March of 2022, providing coverage in the ER and offering same-day appointments in the Family Practice Clinic.

“I love seeing different patients every day with a variety of conditions,” said Vitito. “The ER coverage fulfills my love for the ER and the same-day appointments help improve access to care for patients in the community.”

This new clinic appointment structure (launched in early 2022) provides same-day appointments for both established and new patients who need to be seen for a minor injury or illness.

“This model allows patients to be seen in a clinic instead of being hit with an ER or urgent care cost,” Vitito explained. “I have heard from patients, ‘Wow, I was so happy I could be seen so quickly here in Manning’ and ‘I really appreciate the flexibility in availability to have my children be seen before and after the workday.’ And it has been extremely useful, especially during the cold/flu season.”

Vitito is one of four providers in the Family Practice Clinic who sees patients on a regular basis. The clinic also includes Dr. McLaws, DO, Dr. Luong M.D., and Courtney Rupiper, PA-C.

“Sara has been such a great addition to our clinic team,” said MRHC Clinic Director, Shelby Dickson, RN. “She is always positive and upbeat, and she delivers great care. Plus, her ability to provide same-day access for our patients has really helped improve the care we provide to the community.”

Not only does Vitito enjoy the variety of work she does on a daily basis, but she is also grateful for a supportive team and positive work environment at MRHC.

“We have a fantastic facility to practice in, and I love my coworkers and the team we have here! The providers I work with are all willing to help whenever needed, and the work environment is positive and friendly,” said Vitito. “MRHC has anniversary lunches to celebrate milestones, gifts for nurse practitioner week, provider meals at Christmas, and gifts hospital-wide during the holidays. MRHC also has a Christmas party for all staff to build relationships outside of work. And I have a great work life balance with a flexible schedule.”

For anyone interested in pursuing a career as a nurse practitioner or something similar, Vitito shared this encouraging advice.

“Being a nurse practitioner has endless opportunities. You can work in a big city, rural community, or even teach,” said Vitito. “Take as many clinic or shadowing opportunities as possible to learn what you enjoy, and never be afraid to ask questions because it allows for growth in knowledge. And do not let the amount of schooling deter you! It goes faster than you think.”

If you are in need of a same-day appointment due to a minor injury or illness, call (712) 655-8100. To join the MRHC team, visit or call (712) 655-2072 for more information on current job openings.

Rupiper Finds Calling as PA at MRHC’s Family Practice Clinic

Courtney Rupiper

Courtney RupiperAfter debating a career in business or physical therapy, Courtney Rupiper found her calling as a physician assistant and now works in the Family Practice Clinic at Manning Regional Healthcare Center.

“I started working at a local nursing home when I was younger and fell into healthcare,” said Courtney Rupiper, PA-C. “I felt comfortable with healthcare and helping people. When I went to college, I thought I was going to be a physical therapist, but I quickly learned that wasn’t for me. After doing some job shadowing of PAs, I felt like it was something I could do, and here I am.”

Rupiper joined the MRHC Family Practice Clinic as a Certified Physician Assistant in November of 2017. She completed her undergraduate degree at the University of Northern Iowa and received her PA degree from St. Ambrose University.

“I really enjoy getting to know all the families here at MRHC. And as I grow in my career as a PA, I hope to complete more continuing education so I can be even more help for my patients,” Rupiper said.

In addition to the meaningful work Rupiper does daily, she also values the laid-back feel of working in the clinic, the convenience of working close to home, and the work-life balance MRHC offers.

“MRHC provides a great atmosphere to work in, and I like that you know everyone,” said Rupiper. “It feels like home even when I’m at work.”

Rupiper is one of four providers in the Family Practice Clinic who sees patients on a regular basis. The clinic also includes Dr. McLaws, Dr. Luong, and Sara Vitito who accepts same-day appointments.

“Courtney is a great asset to the MRHC provider team,” said MRHC Clinic Director, Shelby Dickson. “She works hard and always puts a patient’s best interest at the forefront of the care she gives.”

To schedule an appointment with Rupiper, call (712) 655-8100. To join the MRHC team, visit or call (712) 655-2072 for more information on current job openings.


Don’t be the Dealer: Prescription Drug Take Back Day is April 30th

dispose of leftover medications

Manning Regional Healthcare Center (MRHC) encourages everyone to go through their medicine cabinets while spring cleaning this year and take part in Prescription Drug Take Back Day on Saturday, April 30th.

While it may seem convenient to keep leftover medications “just in case” the next time you or a family member are sick, it can be very dangerous.

“Resist the temptation to go to your cabinet to take any leftover medication, especially antibiotics,” said Jen Morris, PharmD, Director of Pharmacy at MRHC. “A big concern with patients not finishing medications as prescribed is a fear of developing antibiotic resistance.”

What is Antibiotic Resistance?
  • Antibiotic resistance occurs when bacteria develop the ability to defeat drugs designed to kill them. Illnesses once easily treatable with antibiotics can become untreatable, leading to dangerous infections.
  • If a patient has a bacterial infection that warrants antibiotic treatment, it is vital they follow their prescription usage directions carefully.
  • Finish the whole treatment of antibiotics, even if you are feeling better, because infections can come back even worse than before if you don’t finish antibiotics.
  • Never use leftover antibiotics to self-treat family members with similar symptoms. Taking leftover antibiotics for a new illness increases your risk of having side effects, making you sicker, or causing a reaction.

Not taking the correct doses of prescribed antibiotics and saving leftover pain pills has evolved from a public health issue to a public safety concern. Research from the National Survey on Drug Use and Health shows that most misused and abused prescription drugs are obtained from family and friends, including medication being stolen from home medicine cabinets.

According to the United States Drug Enforcement Administration (DEA), the drug overdose epidemic in the United States is a public health, public safety, and national security threat. The DEA’s Take Back Day encourages safe, convenient, and responsible means of disposing prescription drugs to help prevent medication misuse and opioid addiction.

Medication Disposal Options

Morris notes that residents have two options available year-round to dispose of unused prescriptions – not just on April 30. dispose of leftover medications

“We have a medication drop box located at the Emergency Department entrance at the hospital and the Manning Pharmacy houses a destruction box uptown as well,” shared Morris. “Residents can discreetly take their leftover medications to these boxes and make sure unused prescriptions are securely destroyed without posing environmental threats.”

Both sites can accept small amounts of liquids, pills, patches, creams, and inhalers. However, needles, sharps, and illegal substances are not allowed. Morris notes that common methods for disposing of unused medicines—flushing them down the toilet or throwing them in the trash—are potential safety and health hazards and are not advised.

For more information about what to do with expired medications, please call MRHC at (712) 655-2072. If you or a family member has concerns about prescription drug abuse, please call the Recovery Center at (712) 655-2300.

MRHC Makes Changes to Enhance Patient Experience

Sara Vitito, ARNP at MRHC who offers same day appointments

Manning Regional Healthcare Center (MRHC) has made recent changes to improve patient accessibility to providers and convenience of care. Sara Vitito, ARNP, joined the Family Practice Clinic on March 8th with the intention to offer more same-day appointments.  Sara Vitito, ARNP at MRHC who offers same day appointments

“We have seen an increase of the need for same day appointments, so we are changing the model of our Family Practice Clinic to accommodate these demands,” shared MRHC Clinic Director, Shelby Dickson, RN. “This new structure will allow our primary care providers to focus on their patients, provide more convenient and accessible appointment options with Sara, and improve the overall patient experience.”

Originally from Omaha and now residing in Defiance, Iowa, Vitito is excited to begin meeting patients. She looks forward to caring for local families and providing a continuum of care from birth until the elderly years.

“We are committed to offering the best health care in the region and we hope that these changes happening in our Family Practice Clinic will improve patient care for locals so they may be seen on the same day as making an appointment,” shared MRHC CEO, Linn Block, RN, BSN, MHA.

New Designated Phone Number for Appointments

MRHC has also designated a new phone number for patients to call when scheduling appointments. Patients can now dial (712) 655-8100 to schedule an appointment in the Family Practice Clinic and Specialty Clinics.

This designated phone line provides ease for patients wishing to schedule appointments for regular well-child visits, annual exams, health concerns, or common sicknesses in the Family Practice Clinic, and services including OB-GYN, Orthopedics, ENT, Podiatry, Urology, Pain Clinic, Wound Care, wellness clinics, and general surgery in the Specialty Clinic.

Appointments for rehabilitation services including physical, occupational and speech therapy should still be scheduled by calling (712) 655-2072. Senior Life Solutions can be reached by calling (712) 655-8262. The number for the Recovery Center at Manning Regional Healthcare Center will remain (712) 655-2300.
If you have any questions or concerns about your health or need to speak directly with someone at MRHC, do not hesitate to call the main line at (712) 655-2072.

Dickson Takes Advantage of Career Opportunities at MRHC

Shelby Dickson

Shelby DicksonMRHC Registered Nurse, Shelby Dickson, is grateful for the opportunity to thrive in a career close to home and make a difference in healthcare. Even at a young age, Dickson knew she was meant to work in the medical field.

“I went to school for radiology and soon realized that I wanted to be involved in the problem-solving piece of patient care,” said Dickson. “I chose nursing because there are so many areas you can work in as a nurse. After getting my CNA and working as an aid on a Med/Surg/Peds floor, I found out that I loved patient care and that it was where I wanted to be.”

Dickson continued with nursing school at DMACC in Carroll and graduated in 2009. She worked in Med/Surg/Peds at Saint Anthony Regional Hospital until 2014 and then worked at a private clinic in Carroll for a year before accepting the health coach position at MRHC.

“At MRHC, employees can potentially wear a lot of hats, and I always took that as an opportunity to learn more and be helpful,” Dickson said. “As the Health Coach, I was a resource for the clinic nurses, so I continued to learn more about the clinic processes which has brought me to the position I am in today.”

Dickson has continued to advance in her career at MRHC and now works as the Clinic Director.

“MRHC has given me opportunities to learn and advance in my career. When the Clinic Director position opened, I had learned enough about the clinic that I was ready to take on a challenge and move up,” she said.

Dickson attributes her ability to advance and excel in her career partially to the management team at MRHC.

“Linn [Block] is always suggesting leadership classes and workshops to help me learn how to be an effective leader. Many managers have been supportive to me when it comes to new obstacles. There is always someone ready to listen and help guide you,” Dickson said.

Even when the pandemic presented new challenges, Dickson felt supported and empowered to make important decisions for staff and patients.

“Administration is always listening to my ideas, and we talk a lot about empathy here – putting yourself in the patient’s shoes. Keeping patients at the center of every decision we make benefits patients,” said Dickson.

The MRHC management team recognizes Dickson’s value to the hospital as well as how she has made significant changes to benefit patients and make the clinic an overall good place to work.

“Shelby has showed continued growth in her ability to lead our Family Practice Clinic, and she is well respected by the team,” said MRHC CEO, Linn Block, RN, BSN, MHA. “Shelby sees her role as ensuring our community has convenient access to quality, primary care providers.”

As for the future of her career, Dickson is eager to continue to advance in her education as well as grow in her role at MRHC.

“I love the people that I work with and the mission of the hospital. I hope to get my bachelor’s degree and take on more responsibilities here at MRHC.”

For a list of current openings or to apply at MRHC, go or call (712) 655-2072 for more information.