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 www.mrhcia.com/careers or call (712) 655-2072 for more information on current job openings.

Carroll Co. Growth Partnership Attends Annual Access Washington Trip

Linn and Dawn in DC
Block and Meyer Voice Area Concerns

By: Pam Kusel

It has been two years since Carroll County Growth Partnership has traveled on their annual Access Washington trip to visit with the Congressional delegation, federal agencies, and others to discuss important issues in Carroll County. COVID-19 and government shut downs kept the group from traveling to Washington DC the past two years. This year, the group brought a full slate of issues to discuss and new faces to experience our nation’s capital.

“I am so thankful for the opportunity to go to Washington DC to advocate for rural healthcare,” said Manning Regional Healthcare Center CEO, Linn Block. “As Iowa saw its first hospital closure this year, the impact of many years of reimbursement pressures will continue to put the future of rural healthcare in jeopardy. MRHC has consistently been a leader in working alongside state and federal policy makers to ensure they understand our challenges as we continue to meet the needs of our community.” Linn and Dawn in DC

Dawn Meyer, Manning City Administrator, said, “We met with all four of the House representatives from Iowa and their staff. We also met with a representative of the Biden administration. We talked about a number of issues specific to Manning. We brought a proposed change for David-Bacon, which is a federal regulation relating to contracts that involve federal money. This is a long-term issue. In the past we have received quick turnarounds, such as the gas line. We also brought up several healthcare concerns; things that are important to MRHC. We felt it was important to support those issues, and Linn (Block) presented very well on that, and we got some good feedback from elected officials.”

Healthcare dominated the trip, being the leading issue brought by private industry. Linn Block, MRHC CEO, asked for continued support and funding of the 340B program, which has a large impact to their bottom line and helping provide healthcare in the Manning area. Both requests were given support from the entire Iowa delegation (four Congressional offices and two Senate offices). Allen Anderson, CEO of St. Anthony Regional Hospital, discussed the importance of the rural demonstration program and the funding support it gives to the Carroll hospital.

Kimberly Tiefenthaler, Executive Director of Carroll County Growth Partnership led the group to DC on her first Access Washington trip. “Access Washington is a phenomenal opportunity for our organization, area businesses, and constituency to bring issues to our nation’s leaders,” stated Tiefenthaler.

The City of Carroll discussed issues regarding the wastewater treatment plant and effluent limitations. This was discussed at all congressional meetings and of the Environmental Protection Agency (EPA), asking for guidance to solve the problem and help the taxpayers of the city of Carroll. Other issues consisted of volunteer EMS support, transportation infrastructure (four-lane Highway 30), Davis-Bacon, Economic Development Administration reauthorization, and housing rehab. All issues gained the support of the Iowa delegation who were willing to help find solutions.

A highlight of the trip was meeting with Will McIntee, Associate Director of Public Engagement with the Biden Administration. The group met with Will at the Eisenhower Executive Office on the White House Campus, just down the hall from the Vice President’s office.

“We attend this trip looking for help and guidance to solve problems that people and businesses are facing here in Carroll County. Some years, CCGP has accomplished those tasks and some years, we continue to build relationships with the leaders in Washington DC. Either way, this trip is a benefit for the people of Carroll County,” stated Tiefenthaler.

Carroll County Growth Partnership invests in this trip every year and is to be used as a resource and benefit to Carroll County. Any leader or business can bring their issue and attend the trip in the future.

Attendees of the trip were: Kimberly Tiefenthaler, Carroll County Growth Partnership; Rick Hunsaker, Region XII Council of Governments; Dawn Meyer, City of Manning; Gene Meiners, Carroll County Supervisor; LaVern Dirkx, Carroll City Councilman; Mike Pogge-Weaver, City of Carroll; Allen Anderson, St. Anthony Regional Hospital; Linn Block, Manning Regional Healthcare Center; and Matt Meiners, Carroll Co. Growth Partnership.

Lymphedema Services Now Available at MRHC

Occupational therapist, Amanda Arneson

“For those experiencing swelling due to lymph node removal or cancer treatments, lymphedema services can be very beneficial,” explained Occupational Therapist Amanda Arneson, MOTR/L, CLT, at Manning Regional Healthcare Center. Occupational therapist, Amanda Arneson

Lymphedema is a pooling of lymph fluid that results in swelling in a portion of the body. If left untreated, the collection of protein-rich fluid provides a culture rich for infection and inflammatory processes. Reduced oxygen transport then decreases healing to compromised tissues and wounds.

Lymphedema is a progressive condition characterized by:

  • Excessive protein in the tissues
  • Excessive fluid in the tissues
  • Chronic inflammatory reactions
  • Excessive deposition of fibrous tissues

“We began seeing more and more patients experiencing the effects of lymphedema, so Amanda became certified to provide treatment for our patients,” said Director of the therapy department, Taylor Nelson, PT, DPT.

Patients will now be available to receive the following treatments at MRHC:

  • Manual lymph drainage
  • Compression bandaging
  • Compression garments
  • Exercise and elevation
  • Education in self-management

To schedule a lymphedema consultation with Amanda at MRHC, call (712) 655-8298.

Tiefenthaler Provides Consistent Specialty Care Across Western Iowa

Kendra Tiefenthaler

When a car accident left a local mother with extensive injuries; significant chemotherapy and radiation treatment resulted in open, non-healing wounds for an area farmer; and non-healing sores on the feet and lower extremities of an elderly gentlemen resulted from the effects of diabetes, the Wound Care team at Manning Regional Health Care Center (MRHC) was able to heal their wounds quickly and effectively.

One integral team member for the Wound Care Clinic at MRHC is Clinical Coordinator, Kendra Tiefenthaler, RN, BSN. Kendra’s role in healthcare has evolved over the years, and she now works as a traveling wound care nurse, providing care throughout Western Iowa clinics, including MRHC. Kendra Tiefenthaler

“My mother had her master’s in health care, and it allowed me to see firsthand how important nursing is and how rewarding health care can be,” said Tiefenthaler. This continues to be true of her healthcare experience as she helps heal numerous patients each year from their open wounds.

Tiefenthaler received her LPN and RN license from Iowa Central Community College. In 2019, she decided to pursue her BSN degree and graduated from Capella University. She has now been a nurse for 12 years and has worked in a variety of healthcare settings including North Central Correctional Facility, St. Anthony Home Health and Hospice, and now serving as the Clinical Coordinator in Wound Care for RestorixHealth.

“Kendra goes above and beyond the call of duty every day, making sure her patients are cared for and that they understand each step of their treatment plan,” said Chelsea Spear, RestorixHealth Physician and Community Liaison. “She is such an essential piece to the wound care clinics, and she prides herself on getting to know each patient within the clinic and community. She always tries to make the day of people around her better.”

Tiefenthaler works at three hospitals regularly, including MRHC, and she fills in at two other clinics as needed.

“Having the opportunity to work at MRHC for three plus years consistently has allowed me to become part of the community,” said Tiefenthaler. “I often feel like I am caring for my own family. Plus, MRHC has a great team environment which allows for good communication and more effective care.”

At the MRHC Wound Care Clinic, Tiefenthaler works alongside Dr. Luong when caring for patients.

“Dr. Luong is an extremely intelligent and caring doctor. Working with him allows our wound care patients to receive excellent and precise care at every visit,” shared Tiefenthaler.

Being a travel wound care nurse allows Tiefenthaler to provide consistent care across multiple locations and help keep care close to home for patients.

“Often times wound care requires multiple visits for positive outcomes,” explained Tiefenthaler. “Having regularly scheduled days in each community has allowed our patients to see a consistent nurse and provider each week while also saving them travel time and expenses.”

“I’m so thankful I was able to go to MRHC for wound care since it’s located in my hometown,” shared a local resident. “I was immediately impressed by Kendra’s genuine concern for my care, her efforts to get answers and help me, along with Dr. Luong’s attention and ongoing wound care treatment. The best thing about the care I received was their genuine care and advocacy.”

As Tiefenthaler reflects on how she has grown in her career, she feels grateful for the role and responsibility she has been trusted with.

“Health care is always evolving and being a clinical coordinator providing a specialty service throughout local western Iowa clinics is motivating and rewarding,” said Tiefenthaler.

MRHC Wound Care Clinic

The MRHC Wound Care Clinic, a recent recipient of RestorixHealth’s Patient Satisfaction Award and Clinical Distinction Award, is dedicated to optimizing outcomes and preventing lower limb loss in patients with non-healing wounds. The approach to wound care is aggressive and comprehensive, coordinating traditional and advanced therapies and techniques that are proven to reduce healing time and improve healing rates. Since non-healing wounds rarely result from a single cause, the Wound Care Clinic begins with a thorough evaluation and diagnostic testing to determine the underlying cause of the wound. A treatment plan is then developed to give patients the best chance for healing. Most treatments are covered by Medicare/Medicaid, HMOs, and other private insurance.

The MRHC Wound Care Clinic is held every Thursday. For more information about treatment plans, please call 712-655-8100.

About RestorixHealth

RestorixHealth, the nation’s leading wound care solutions company, develops and operates advanced wound healing centers and provides wound healing direct-care services, education, and advanced wound supplies nationwide. Forging strong relationships with their partners, RestorixHealth’s customized wound healing programs and solutions increase the access to care, lower or avoid direct care costs, reduce hospital admissions, improve outcomes, and increase patient and partner satisfaction. For more information, visit www.RestorixHealth.com.

MRHC Wound Care Clinic Receives Patient Satisfaction and Clinical Distinction Awards

MRHC Wound Care Clinic Receives Awards

Manning Regional Healthcare Center (MRHC) is pleased to announce the Wound Care Clinic is a recipient of RestorixHealth’s Patient Satisfaction Award and Clinical Distinction Award. Recipients of these awards meet or exceed national patient satisfaction and quality benchmarks over a set period. The Clinical Distinction Award also acknowledges exceptional success in wound healing rates and safety goals.

“This achievement reaffirms our commitment to the patient experience and the quality of care that our Wound Care Clinic provides its patients every day,” said MRHC CEO, Linn Block, RN, BSN, MHA. “We are proud to be a recipient of two awards that recognize the hard work and dedication of our staff.”

RestorixHealth launched its Center Recognition Award for Patient Satisfaction program to recognize those centers that have met or achieved a patient satisfaction score of 96% or higher. The Clinical Distinction recognition program is meant to recognize centers that have demonstrated success by meeting or exceeding patient safety goals along with a 90% healing rate.

One local resident is a testament to the positive patient satisfaction and overall effectiveness of the MRHC Wound Care Clinic.

MRHC Wound Care Clinic Receives Awards“I’m so thankful I was able to go to MRHC for wound care since it’s located in my hometown,” said Manning resident, Jeanne Kerkhoff. “I was immediately impressed by Kendra’s genuine concern for my care, her efforts to get answers and help me, along with Dr. Luong’s attention and ongoing wound care treatment. The best thing about the care I received was their genuine care and advocacy,” she shared.

The MRHC Wound Care Clinic is dedicated to optimizing outcomes and preventing lower limb loss in those patients with non-healing wounds. The approach to wound care is aggressive and comprehensive, coordinating traditional and advanced therapies and techniques that are proven to reduce healing time and improve healing rates. Since non-healing wounds rarely result from a single cause, the Wound Care Clinic begins with a thorough evaluation and diagnostic testing to determine the underlying cause of the wound. A treatment plan is then developed to give patients the best chance for healing. Most treatments are covered by Medicare/Medicaid, HMOs and other private insurance.

Manning’s clinic is staffed by Dr. Thang Luong, M.D., Kendra Tiefenthaler, RN and supported by Taylor Potthoff, RN and Elaine Macumber, RN. Integrating a team of wound care professionals optimizes patient care while offering the most advanced healing options.

The MRHC Wound Care Clinic is held every Thursday from 8 a.m. to 2 p.m. For more information about our treatment plans, please call 712-655-8112.

About RestorixHealth

RestorixHealth, the nation’s leading wound care solutions company, develops and operates advanced wound healing centers and provides wound healing direct-care services, education and advanced wound supplies nationwide. Forging strong relationships with their partners, RestorixHealth’s customized wound healing programs and solutions increase the access to care, lower or avoid direct care costs, reduce hospital admissions, improve outcomes and increase patient and partner satisfaction. For more information, visit www.RestorixHealth.com.

Diabetic Finds Comfort from MRHC Wound Care Clinic

wound care team

“I woke up one morning and noticed that the bottom of my foot was sore. It was tender to the touch and the pain was excruciating to walk. I knew right away that I needed to get into the doctor and have it evaluated,” said Ralph Dobler of Manning.

Although Ralph had experienced the effects of diabetes for several years prior, he was following a proper diabetic diet, he was watching his health and ensuring he was keeping active. Unfortunately, Ralph had learned the hard way a few years prior that if he doesn’t take care of his wounds, it could lead to amputation.

“I knew that if we could get on top of the wound right away that we would have the potential to save my foot.  At 74 years old, Ralph has been dealing with the side effects of diabetes for many years.

More than 29.1 million Americans have diabetes and sixty to seventy percent of people with diabetes have limited or no feeling in their feet. “It’s much easier to treat a minor foot problem before it becomes serious,” said Kendra Tiefenthaler, RN, Clinical Coordinator for the MRHC Wound Care Center. Kendra Tiefenthaler

The wound care team believes that Ralph’s immediate attention to the issue and willingness to commit to weekly treatments until the wounds were healed is what ultimately prevented him having an amputation.

Approximately 25-30% of patients with diabetes develop a foot sore or ulcer. Though foot ulcers can be anywhere on the foot, most occur on the ball of the foot or on the bottom of the big toe.

There are several reasons why diabetic patients have foot problems, but the most common reason is that they suffer from nerve damage called neuropathy, which causes loss of sensation in the feet.  These patients also suffer from poor circulation, which can make your foot less able to fight infection and heal.

Signs of a Possible Foot Ulcer:
  • Lack of sensation (feeling) in your feet
  • Feeling of “pins and needles” in your feet
  • Feet hurt while walking or resting
  • Sores don’t heal
  • Skin on your feet becomes thick, dry or scaly,
  • Calluses develop easily on the soles of your feet

“At MRHC, we have the ability to treat any open wounds caused from vascular complications, post-surgical procedures, diabetes and more,” said Tiefenthaler.  “Oftentimes patients will see the most benefit from weekly treatments where the provider addresses any concerns, evaluates wound progress, and cleans/redresses the wound to ensure timely healing.”

How to care for your feet and prevent diabetic ulcers:
  • Check your feet daily. Look for blisters, cuts and scratches. Use a long-handled mirror or place a mirror on the floor to see the bottom of your feet. Always check between your toes.
  • Keep your feet clean. Wash daily, dry carefully – especially between the toes.
  • Moisturize your feet. Apply a moisturizer as recommended by your physician, but never apply between toes as that can lead to a fungal infection.
  • Do not walk barefoot. That includes on sandy beaches and pool/patio areas.
  • Wear properly fitted shoes. Shoes should be comfortable when purchased. Do not wear narrow, pointed toe or high-heeled shoes.
  • Inspect the inside of your shoes daily. Check for foreign objects, tears or rough areas on the inside of the shoe.
  • Do not wear shoes without socks or stockings. Wear clean, properly fitted socks. Cotton or cotton-blend socks are recommended.
  • Avoid temperature extremes. Test water temperature with your hand or elbow prior to bathing. Do not soak your feet in hot water or apply a hot water bottle. If your feet feel cold at night; wear socks.
  • Trim your toenails regularly. Always cut your nails straight across.
  • Do not use over-the-counter remedies for corns. See a podiatrist to have these evaluated.
  • Avoid crossing your legs. This causes pressure on the nerves and blood vessels, resulting in less blood flow to your feet.

As we wrap up American Diabetes Month, MRHC wants to remind people with diabetes that they are at a higher risk for non-healing foot wounds – and therefore amputations – than most Americans. One in four patients with diabetes will develop a foot ulcer in their lifetime. The wound healing center at MRHC can provide guidance for prevention and treatment of these wounds.

If you are experiencing pain or complications from an open wound, contact the MRHC Wound Care Clinic at (712) 655-8100 to request a wound care consultation or treatment. Physician referrals are not required.