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The Iowa Civil Rights Commission is selling off some of its display replicas today, including exhibits commemorating a landmark 1948 DSM lunch counter protest led by civil rights leader Edna Griffin.

Catch up fast: The commission's offices recently relocated, leaving it without room to display the items.

The Iowa State Historical Society declined to accept them because they are not originals and did not fit with their collection needs, commission director Kristen Stiffler tells Axios.

Of note: The commission couldn't donate the displays to something like a nonprofit historical society because Iowa policies require state property be sold via GovDeals, Stiffler says.

What's next: Bidding ends today at 3:26pm.

Iowa commission selling its civil rights display replicas

The commission's offices recently relocated, leaving it without room to display the items.

An online auction to sell these Iowa civil rights display replicas, documents and posters ends today. Photo: Courtesy of the Iowa Civil Rights Commission

The Iowa Civil Rights Commission is selling off some of its display replicas today, including exhibits commemorating a landmark <a class="gtmContentClick" data-vars-link-text="1948 DSM lunch counter protest" data-vars-click-url="https://blog.lib.uiowa.edu/iwa/2020/12/01/edna-griffin-civil-rights-activist/" data-vars-content-id="5cc870c3-cda5-43c1-ad9d-2dc1259a4b54" data-vars-headline="Iowa commission selling its civil rights display replicas" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://blog.lib.uiowa.edu/iwa/2020/12/01/edna-griffin-civil-rights-activist/" target="_blank">1948 DSM lunch counter protest</a> led by civil rights leader Edna Griffin.Catch up fast: The commission&#x27;s offices recently relocated, leaving it without room to display the items.

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Axios Des Moines, anchored by Jason Clayworth and Linh Ta, is here to help readers get smarter, faster on the most consequential news and developments unfolding in their own backyard.

Moxie Kitchen + Events opened last week in the former Godfather's Pizza location across from Uptown Shopping Center.

Why it matters: It'll help metro entrepreneurs start food businesses with minimal overhead, Kali Brudos, one of its owners, tells Axios.

State of play: The commercial kitchen is available for monthly or hourly rentals.

Moxie also has an event space for up to 100 people, preferably using catering services from Moxie's kitchen users, Brudos says.

Zoom in: Kali and her husband, AJ, also run DSM Pasta Co., and previously worked out of a shared kitchen in the Mickle Center.

They wanted to expand shared kitchen opportunities in DSM to include more space where food businesses can host dinners and entertain.

Owners of metro-area food services Nourished and Crafted Food Services are Moxie's business partners.

Details: Moxie's weeknight rentals for events start at $500.

Kitchen rentals start at $35 an hour or users can also sign up for monthly membership packages.

Moxie Kitchen + Events opens in Des Moines

This new commercial kitchen includes event space for up to 100 people.

A photo of Moxie Kitchen + Events' store.

Moxie Kitchen + Events is located at 4119 University Ave. in DSM. Photo: Jason Clayworth/Axios

<a class="gtmContentClick" data-vars-link-text="Moxie Kitchen + Events" data-vars-click-url="https://www.moxiedesmoines.com/" data-vars-content-id="57f23c0e-a2f7-48d1-88ad-5d3eba6d47b2" data-vars-headline="Moxie Kitchen + Events opens in Des Moines" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.moxiedesmoines.com/" target="_blank">Moxie Kitchen + Events</a> opened last week in the former Godfather&#x27;s Pizza location across from Uptown Shopping Center.Why it matters: It&#x27;ll help metro entrepreneurs start food businesses with minimal overhead, Kali Brudos, one of its owners, tells Axios.

Food and Drink

If you're stumped on what to get your friend or loved one this holiday season, we're here with a hyper-local list of gifts anyone will love.

Why it matters: Buying local means you're helping a nearby business that's more likely to spend and hire within our community.

Plus: Going out shopping is way more fun than going on Amazon!

☕️ Coffee: Chain & Spoke is selling 12 days of coffee and food pairings from Dec. 13-24. $80.

🍔 Restaurant meals: Full Court Press restaurants are offering a free $10 gift card with the purchase of a $50 card, or $20 with a $100 gift card.

Gift cards are only good for the location they were purchased.

🍺 Beer lovers: Purchase a PubPass for $25 and get one beer at 20 different local spots, including Confluence and Smash Park.

🍦 Sweet treat: Black Cat Ice Cream sells gift certificates.

🎶 Jazz lovers: Give an annual membership to Noce, which includes free shows, discounts for friends and free private rentals for sustaining members. $690.

💃 Broadway fans: Season tickets are available at the Civic Center or you can buy tickets for upcoming shows like "Mamma Mia!" and "MJ The Musical."

🍿 Moviegoers: Give an annual membership to Varsity Cinema starting at $50, which includes $5 off screenings, $1 off popcorn and a free magnet.

🎄 Presents? In this economy? Get a humorous wood tree ornament from RAYGUN. $12.

🧗‍♀️ Get 10% off punch cards to go bouldering or rock climbing at Climb Iowa.

🥕 Campbell's Nutrition is offering 20% off today on items like groceries, books and home goods. They also sell Lua's popular Climbing Kites drinks.

🎨 Browse Iowa-themed apparel, local jewelry and art from ArtForce Iowa. Sales help local youth.

🍬 The Peppermint Trail: Shop, dine and ride a trolley through the Ingersoll and Roosevelt district on Saturday during its special day-long holiday event.

👗 Saturday Market: Stop at The New Northwestern tomorrow  to shop for local skincare products, vintage clothes, baked goods, books and art. 3-6pm.

🎅 Jingle in the Junction: Businesses along Valley Junction extend their hours on Dec. 14.

Des Moines' ultimate local holiday gift guide

From jazz club memberships to funny ornaments, we've got some great gift ideas.

a bauder's peppermint bar (left) and holiday christmas albums (right)

A Bauder's peppermint bar and holiday CD's from Zzz. Both shops are on The Peppermint Trail on Saturday. Photos: Courtesy of The Avenues

If you&#x27;re stumped on what to get your friend or loved one this holiday season, we&#x27;re here with a hyper-local list of gifts anyone will love.Why it matters: Buying local means you&#x27;re helping a nearby business that&#x27;s more likely to spend and hire within our community.

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Driving the news: By 2034, adults over 65 years old are expected to outnumber children for the first time in U.S. history, according to the U.S. Census Bureau.

Why it matters: Iowa is already suffering from a nursing home crisis as staffing shortages and facility closures persist.

But the state's rural parts are already making changes to meet these demographics needs, and could help lead the nation as a positive example for aging care.

By the numbers: Older Iowans will make up more than 20% of the population in the majority of the state's counties by 2030, according to the nonprofit LeadingAge Iowa.

Our state's 85+ population is expected to grow by over 90% by 2040.

What they're saying: Caring for the next generation of seniors will need to go beyond just adding nursing homes, Iowa State sociology professor David Peters tells Axios.

It will require towns to think holistically about their senior services and consider how to help people live in their homes for longer.

It will also require upgrading homes and technology to meet seniors' needs.

Iowa, federal government, work to ease financial burden of home assistance

Illustration of an elderly hand touching a puzzle of a hundred dollar bill

Breaking financial barriers that commonly block in-home assistance or care at small nursing home facilities are among the elderly care crisis solutions advocated by AARP.

Why it matters: The organization, one of the nation's largest and most influential interest groups, works for the dignity and rights of seniors.

Its members are calling for lawmakers and elderly care regulators to rethink how long-term care services are provided, AARP Iowa director Brad Anderson tells Axios.

Zoom in: Nursing home facilities that operate more like a home with a small number of residents are frequently more efficient and provide better quality of care than large-scale facilities, according to AARP.

Yet most are paid for out-of-pocket and not covered by Medicaid, keeping them out of reach for most people.

Meanwhile, non-medical in-home services that can allow elderly people to live in their homes longer also frequently require a special waiver or are not covered by Medicaid.

Hundreds of thousands of older or disabled people who qualify for Medicaid are annually on waiting lists for home care, according to a five-year analysis published last year by KFF, an independent health policy research organization.

Of note: State Medicaid officials are currently working with the federal government to improve procedures and expand home services, a spokesperson for the Iowa Department of Health and Human Services tells Axios.

How a small town can help its aging population

An Iowa town of 2,000 people is setting the standard for how cities across America can help support their aging populations.

Driving the news: Sac City in northwest Iowa was designated as a "smart" senior town by Iowa State professor David Peters and visiting scholar Ilona Matysiak.

The two co-authored a paper examining Iowa rural towns with older demographics. Their research showed how amenities like nearby healthcare, groceries and even child care resulted in seniors reporting a higher quality of life — and subsequently for younger people as well.

State of play: Despite Sac City's shrinking population, government and community efforts to keep a certain level of amenities helped residents overall.

Zoom in: The research paper, published in 2023, examined communities' initiatives to improve seniors' quality of life.

In 2016, for example, Sac City launched an initiative to help residents obtain care from medical specialists — a struggle since the closest major hospital is hours away.

Community members contacted a Sioux City hospital, convincing some doctors that if they came to Sac City one day a month, they would get booked from 8am to 8pm and be assured of a full paycheck.

Working with the hospital, volunteers drove seniors to their appointments and made sure they saw all their specialists in one day.

What they're saying: "It's a smart way to think about a problem with a solution that's really innovative and it relies on people's willingness to invest in their community and each other," Peters says.

Since then city officials have kept responding to seniors' requests — for instance, converting most of the basketball courts to pickleball courts.

Local volunteers have helped build amenities like ramps to doors and rails in bathrooms.

The bottom line: "The more that seniors are active in their mind and their body and are connecting with other people in the community ... the better health outcomes," Peters says.

How Google Nest or Amazon Echo can help with at-home care

iowa state students at a seniors nursing home

Students from Iowa State University work on a pilot project helping renovate seniors' homes for more comfortable living. Photo: Courtesy of AARP Iowa

The Amazon Echo may do more than make your life more convenient — it can also help with fall detection or remotely check in with a loved one.

Why it matters: 83% of older Iowans say they want to age in place, according to an AARP survey.

Although gadgets and home improvements can't replace human care, they can help with simple tasks and 24/7 monitoring.

Zoom in: Solutions can be as simple as changing door knobs to levers for easier grip, carpeting staircases or installing grab bars for showers.

They can also involve more technology to help with monitoring or voice control.

AARP launched a "smart home pilot project" in Charles City last year, installing Apple Home Kits in 13 houses. Beyond being able to answer questions through voice command, the kits can alert family members and detect unusual movements.

What they're saying: Economic costs are the biggest barriers for Iowans wanting to add amenities to their homes, Brad Anderson, executive director of AARP Iowa, tells Axios.

Modifying a home for an aging person can cost $3,000 to $15,000 on average.

What we're watching: The state's Medicaid funding for seniors primarily goes towards funding traditional care like nursing homes (70%), followed by home and community services (30%).

Anderson says he believes it should be a 50-50 split, which will ultimately save the state money by keeping more Iowans out of nursing homes.

There's also local and federal programs that can provide grant money, including a Des Moines' initiative that opens January 4 and a USDA loan for low-income and rural households.

A photo of Iowa Long-Term Care Ombudsman Angela Van Pelt.

Iowa Long-Term Care Ombudsman Angela Van Pelt. Photo: Courtesy of Van Pelt's office

"This is unfortunately one of those issues where it doesn't seem to bother people until they actually do find themselves in that situation."

Angela Van Pelt, Iowa's long-term care ombudsman, responding to Iowa Public Radio's question in August about whether there is political will to substantially reform nursing home care and oversight

Of note: Van Pelt concluded that change must be driven by citizens.

Editor's note: This is part of a two-part series that first appeared in Axios Des Moines.

Read day 1 to go deeper into some of the problems facing Iowa's elder care.

Read day 1 to go deeper into some of the problems facing Iowa's elder care

Axios investigates: Solutions to Iowa's "gray tsunami" care crisis

By 2034, seniors are expected to outnumber children for the first time ever.

Illustration of a pattern of rocking chairs, with one emanating a bright color. 

A &quot;gray tsunami&quot; is heading our way.Driving the news: By 2034, adults over 65 years old are expected to outnumber children for the first time in U.S. history, according to the <a class="gtmContentClick" data-vars-link-text="U.S. Census Bureau" data-vars-click-url="https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html" data-vars-content-id="bc4cb0af-7fc9-4641-b2b6-3cebc6de5fa5" data-vars-headline="Axios investigates: Solutions to Iowa&#x27;s &quot;gray tsunami&quot; care crisis" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html" target="_blank">U.S. Census Bureau</a>.

Health

Sam and Leslie Wells planned ahead for years on how to obtain the best care for her in the final months of a terminal illness.

But what they believed to be one of the state's finest facilities failed them, Sam tells Axios.

Why it matters: The Wells' situation is one that many families around the state say they are contending with right now.

Iowa is part of a national nursing home crisis that came to a head during the pandemic, with critical staffing shortages that still persist.

Recently alleged nursing home abuse or neglect in the metro include a client who contracted gangrene and had to have a leg amputated and a person who froze to death.

Catch up fast: Leslie had leukodystrophy, a genetic disease that causes cognitive impairment, movement disorders and seizures.

The couple moved to Edgewater's independent living center in West Des Moines in 2018, looking ahead to the possibility that she'd eventually need the center's long-term care.

She moved into the facility's long-term care on Jan. 19, 2021.

Yes, but: Leslie stayed there just over a month before Sam says he had her transferred to Deerfield assisted living facility in Urbandale because of poor care, which he believes was due to staffing shortages.

Leslie's care improved and she regained some weight in the weeks after she was relocated, Sam says. She died about four months later.

Edgewater declined to comment on the allegations from the Wells' or other cases documented in inspection reports, citing privacy restrictions.

The facility has not been short-staffed in the last five years, Lisa Ryan, director of communications for WesleyLife, Edgewater's parent company, said in a statement to Axios.

Inspection reports during that time also do not reflect understaffing issues at the facility.

Zoom in: Sam's handwritten notes document three times within a month when he alleges Leslie soiled herself while waiting as long as 90 minutes for bathroom assistance at Edgewater's long-term care facility.

They also show she fell five times, including an incident on Feb. 19, 2021, that resulted in a head injury later documented in a state complaint.

Of note: Edgewater's care plan did not address Leslie's falls.

The facility also lacked documentation showing whether its staff had notified her doctor or family about the Feb. 19, 2021 fall, as is required under federal rules for nursing homes that accept Medicare or Medicaid, according to state inspection documents.

The facility was not fined in Leslie's case but paid a $9,500 fine in July 2022 linked with falls involving other residents, state documents show.

Separately, Edgewater was fined after a resident was found in November 2019 outside without shoes for at least 20 minutes just before 5am.

Her toes were purple but she was otherwise OK, according to the state's report of the incident.

The $500 fine cited a malfunctioning door alarm.

Zoom out: Iowa does not require minimum staffing ratios in nursing homes. Its rules instead focus on whether facilities meet resident needs.

The state's direct-care nursing home staffing standards amount to just over two hours per resident per day for a 100-bed facility, according to a 2021 report by the National Consumer Voice for Quality Long-Term Care.

That's just over half of the national staff mandate proposed earlier this year by the Biden administration.

State of play: Sam and his family now advocate for nursing home reforms.

"The most vulnerable in our state are being abused and neglected at the places most trusted with their care. When are we going to protect those Iowans' right to life?" their daughter Dacè Wells wrote to lawmakers in June.

Nursing home closures accelerate from pandemic

Data: State of Iowa; Chart: Axios Visuals

Since 2020, Iowa has experienced a sharp increase in nursing home closures statewide.

Why it matters: The closures are primarily due to a lack of available workforce to help keep facilities afloat, Brent Willett, president of Iowa Health Care Association previously said.

Shortages can lead to lower care quality.

By the numbers: In 2021, one nursing facility closed in western Iowa.

By 2022, that accelerated to 17 nursing homes

The big picture: 13% of the nation's total nursing home closures in 2022 occurred in Iowa, Radio Iowa reports.

Staffing shortfalls projected for years to come

Illustration of a police light on top of a "Help Wanted" sign.

Nearly 42% of Iowa's nursing homes have self-reported staffing shortages, according to data published earlier this year by the AARP.

Why it matters: It's a national problem that is expected to persist for years, according to a report in August from the American Health Care Association (AHCA).

Zoom in: Iowa's nursing home staff shortages were ranked as the 11th-worst in the U.S. by the AARP.

Minnesota topped the list, with almost 60% of facilities with staffing shortfalls. Kansas and Wisconsin were both above 45%.

What they're saying: The average hourly rate for Iowa nursing home workers is around $16, which is lower than the rate in many other industries and makes it difficult to find or retain staff, Brad Anderson, president of AARP Iowa, tells Axios.

Plus, facilities in rural areas are often spread out in less densely populated areas, which can make it harder to find staff, he added.

The big picture: The AHCA says the nursing home industry lost 250,000 employees, or about 15% of its workforce, during the pandemic.

That's contributed to the closure of nearly 600 nursing homes nationally since 2020.

And more than half of those still operating were turning away prospective patients as of June.

The return of pre-pandemic workforce levels are not anticipated until 2026, according to the AHCA.

Nursing home complaints double between 2019 and 2022

Illustration of a tiny person carrying a large magnifying glass on his back

Iowa's "immediate jeopardy" nursing home complaints more than doubled — from 39 to 83 — between 2019 and 2022, according to data from the Iowa Department of Inspections, Appeals and Licensing.

Why it matters: They're among the most serious level of complaints — situations where a provider's noncompliance resulted in serious injury or death, or could have done so.

They took priority over lower-level complaints during the pandemic, which led to a backlog in other investigations.

Zoom in: There were 410 total complaints pending against Iowa nursing homes that were at least 30 days old in June 2022, according to Iowa Capital Dispatch.

Of those, 201 were more than 120 days old.

State of play: The inspections department reduced the number of pending complaints to 161, a more than 60% reduction between June and August of this year.

All immediate-jeopardy complaints were investigated within a federally required timeframe, generally three business days, agency spokesperson Stefanie Bond tells Axios.

The big picture: Multiple states have bigger complaint or facility inspection backlogs than Iowa, according to a review of federal data published in February by Newsweek.

Roughly 22% of Iowa nursing homes had not been inspected every 15 months as required under federal law.

More than 50% of inspections were overdue as of Feb. 19 in Missouri, Alabama, Kentucky, Idaho and Maryland.

Iowa nursing homes were fined more than 1,000 times in three years

Illustration of a dollar-shaped weight causing cracks in the ground

Iowa nursing homes were fined or denied payment as a penalty more than 1,000 times in the last three years, according to data published in September from the Centers for Medicare and Medicaid Services.

State of play: The fines resulted in more than $12.7 million in penalties, the 14th highest state total in the country.

Iowa had the second-greatest number of penalties per capita behind Massachusetts.

Zoom in: Two Iowa nursing homes are listed as Special Focus Facilities (SFF) and are operating under additional scrutiny by the Centers for Medicare and Medicaid Services (CMS) because of a history of serious quality issues — Arbor Court of Mount Pleasant and Aspire of Primghar.

Meanwhile, 10 others are SFF candidates, including one cited for violations tied to four resident deaths, Iowa Capital Dispatch reports.

Axios investigates: Iowa's nursing home crisis

Deaths and injuries at nursing homes have been attributed to deficiencies in care.

Leslie Wells fell and was injured at a West Des Moines nursing home in early 2021. Her husband, Sam Wells, contends widespread nursing home staffing shortages are to blame. Photos: Courtesy of Sam Wells; Jason Clayworth/Axios

Sam and Leslie Wells planned ahead for years on how to obtain the best care for her in the final months of a terminal illness.<ul><li>But what they believed to be one of the state&#x27;s finest facilities failed them, Sam tells Axios.</li></ul>

Metal detectors will be in place at nearly all Iowa Events Center events in coming months, general manager Chris Connolly tells Axios.

Why it matters: They've been used for years at Wells Fargo Arena's entrances as a screen for weapons— but other areas of the complex, like its convention center space where hundreds of thousands of people visit each year, have not had them.

"It'll make us a lot more safe. It's a big deal," Connolly told Polk County Supervisors during a meeting last week.

Details: The equipment and security upgrades will cost around $375,000.

A grant from the Iowa Department of Homeland Security and Emergency Management will cover most of the expenses.

State of play: The center is owned by Polk County but leased to Oak View Group, an international live entertainment management company whose rules restrict weapons in their facilities.

More than 800,000 people attended events at the Iowa Events Center in the fiscal year that ended in June 2022, according to the facility's most recent annual report.

Flashback: An Iowa Wild scoring official resigned last year after arena managers refused to allow him to bring a gun into the building.

Iowa Events Center to expand use of metal detectors

Nearly all events will soon include weapons screenings.

Metal detectors will be in place at nearly all Iowa Events Center events in coming months, general manager Chris Connolly tells Axios.Why it matters: They&#x27;ve been used for years at Wells Fargo Arena&#x27;s entrances as a screen for weapons— but other areas of the complex, like its convention center space where hundreds of thousands of people visit each year, have not had them.

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