Nursing Homes in Iowa

Of the 3,155,070 people who call the state of Iowa home, 17.5% or 553,575 of those are age 65 and older. Iowa has diverse programs to help seniors pay for long-term care services, including several levels of Medicaid that can be used to pay for care for seniors who meet income and asset guidelines.

For around 55,000 Iowa seniors, nursing homes provide the right level of care to ensure they are healthy. Nursing home care provides elderly and frail seniors with round-the-clock access to care from qualified nursing professionals. The average cost for this care in Iowa is $6,570 per month according to the 2020 Genworth Cost of Care Survey.

If you are considering nursing home care for an elderly loved one, you have many options both to find care and pay for it. This guide helps you learn your options, what assistance is available for your loved one and how to use Medicaid to pay for care.

The Cost of Nursing Home Care in Iowa

Compared to national averages, Iowa has lower-than-average costs for senior care. If your senior family member moves into a nursing home in a semiprivate room, the cost averages $6,570 a month according to the 2020 Genworth Cost of Care Survey. This is significantly lower than the national average of $7,756. Iowa’s cost is fairly low compared to surrounding states as well. In Illinois, seniors and their families pay an average of $6,235. Wisconsin seniors pay an average of $8,684. Minnesota has a much higher cost at $11,026, while South Dakota is closer at $7,011. In Nebraska, the average is $7,194, while seniors in Missouri have an average cost of $5,080.

Throughout the state, nursing home costs vary tremendously. The state’s average is $6,570, but in Des Moines seniors pay much more at $7,148. Ames is close to this as well at $7,080. Davenport has the lowest average cost at $6,235, while Iowa City is closer to the state average at $6,859. Seniors in Cedar Rapids pay close to the state’s average at $6,540, as do seniors in Sioux City, where the average is $6,509. Waterloo is one of the higher-cost cities at $7,118. Dubuque averages $6,722.

Iowa

$6570

Davenport

$6235

Sioux City

$6509

Cedar Rapids

$6540

Dubuque

$6722

Iowa City

$6859

Ames

$7080

Waterloo

$7118

Des Moines

$7148

Nursing home care, which averages $6,570 in Iowa, is just one care option families have when their senior loved one needs extra assistance. Seniors who can live relatively independently but need just a little help during the day may choose adult day care. The state’s average cost for this is $1,353. Those who want help with activities of daily living in a comfortable apartment setting may choose assisted living, which costs an average of $4,073. In-home care averages $4,767, while seniors who need medical care at home may need home health care. This care option averages $4,957 a month.

Nursing home care

$6570

Adult day care

$1353

Assisted living

$4073

Home care

$4767

Home health care

$4957

Does Medicaid Cover Nursing Home Care in Iowa?

More than 775,000 Iowans are enrolled in Medicaid, including nearly 10% of the older adults in the state. Medicaid helps seniors cover the cost of board and care, laundry services and the medical equipment and treatments they need to stay healthy during their stays in nursing homes.

There are 431 nursing homes licensed to operate in Iowa, and all of them accept Medicaid as a payment option. Together, they care for more than 55,000 residents in safe therapeutic environments where trained staff provide supervision and rehabilitation services. The state’s Long Term Care Partnership Program assists seniors with financial needs, managing many of the costs of staying in a nursing home, along with some secondary costs such as transportation to off-site facilities. Seniors on Medicaid who meet the admission criteria for a nursing home but choose to remain in their own homes can do so safely with help from the Home and Community Based Waiver (HCBS) program.

Medicaid Eligibility in Iowa

Applications for Medicaid in Iowa may be submitted online or by phone, or a paper application can be dropped off at a local Human Services Office. New applicants are interviewed by phone to establish both financial and medical needs, and documents may be requested to establish financial eligibility for the program. While this process can take time to complete, it should not delay an applicant seeking necessary treatment. On approval of a beneficiary’s application, Medicaid can retroactively pay for covered expenses obtained during the application period.

Iowa Medicaid requires applicants to meet the financial limitations for participation in the program. To qualify, a single adult must earn less than $30,276 a year and possess countable assets of less than $2,000. A married couple applying for Medicaid together must earn less than $60,522 and have assets worth no more than $3,000, while a married couple where only one partner applies has an income limit of $2,523 a month and asset limits of less than $2,000 for the applicant and $137,400 for the non-applicant spouse.

Not all assets are considered part of the financial assessment for Medicaid in Iowa. While only a Medicaid intake worker can state definitively what is or isn’t countable, applicants are generally exempt from counting a car owned for personal use and up to $595,000 in equity in a single home. Investment properties, second vehicles, certain retirement savings and other assets may be counted, but personal belongings generally aren’t. Intake workers look at income and assets reaching back over a 60-month lookback period, and new applicants may be asked to submit documents relating to any large transfers of property during this time.

2022 Basic Medicaid Income Limits for Seniors in Iowa

	Income limits*	Asset limits
Single Applicant	$30,276	$2,000
Two-Person Household (Only One Person Applying)	$30,276	$2,000 for the applicant $137,400 for non-applicant
Two-Person Household (Both People Applying)	$60,522	$3,000

*Per year

In addition to the financial and medical need criteria, Medicaid in Iowa has other requirements:

Applicants must be U.S. citizens and permanent residents of the state.
Applicants may be asked to demonstrate their eligibility with proof of citizenship and residency before a request for coverage can be approved.

How To Apply for Medicaid in Iowa

Iowa seniors have several ways to apply for the Medicaid program. Online applications are available through the state’s Department of Human Services website, as is a downloadable application that can be printed out and mailed to the program at Imaging Center 4, PO Box 2027, Cedar Rapids, IA 52406. Applications can be submitted over the phone by calling (855) 889-7985, and in-person appointments are available at Human Services offices around the state.

Information You Will Need:

Social Security and Medicare cards or award letters
A certified copy of the applicant’s birth certificate
Bank statements for the previous 60 months before the application date, including accounts that have been closed
Proof of income for the previous 60 months before the application date (including 1099s, 1040s and other tax forms)
Verification of pension income, which must include a letter from the pension provider
Proof of citizenship for applicants born outside the United States
Copies of life insurance documents
Property deeds, if any
Proof of any real property sold or transferred in the 60 months before the application date
Car registration or title, including insurance documentation
Burial contracts and deeds to burial plots, if any
VA discharge papers (DD-214) if the applicant is a veteran
If applicable, copies of power of attorney, final will and trust documents

Additional Medicaid Support and Resources for Seniors in Iowa

Applying for Medicaid in Iowa can be a complicated process many seniors have trouble navigating alone. These resources are available to help new Medicaid applicants successfully file and work through their applications and understand the process.

Resource	Contact	Service
vvvvv	(866) 468-7887	Iowa's Aging & Disability Resource Centers (ADRC) are a large network of interconnected service providers that help seniors learn about long-term care options in the state. The ADRC network provides information and guidance for seniors, adults with disabilities and families looking for placement in a care facility. ADRC volunteers can help with the Medicaid application process and refer applicants to other resources for additional information.
vvvvv	Online Only	The American Council on Aging offers an online Medicaid Eligibility Test for families that want to know if their senior loved ones qualify for assistance before starting the application process. The online Spend Down Calculator also helps couples figure out how much of their assets must be spent before they become eligible for benefits.
vvvvv	(855) 889-7985	Benefits.gov is a federal website that provides basic information about Medicaid in Iowa, including the maximum income and assets for new applicants. As a starting point, it can be a helpful resource for seniors and their families who are looking for information before applying for Medicaid. The site also includes information that can be used to contact the right resources for applications, case manager assistance and other benefits.

Does Medicare Cover Nursing Home Care in Iowa?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

Meals
A semiprivate room
Medications
Skilled nursing
Physical therapy
Occupational therapy
Speech therapy
Audiologist care
Medical supplies
Medical social services
Nutritional counseling
Ambulance transportation

What Isn’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support and Resources in Iowa

Seniors and families looking for nursing home care may be interested in the help Medicare may have to offer. Though health insurance is not a permanent solution, it can provide valuable support in the beginning. Trained advisers at these organizations can provide more information for people who need help with their long-term care situations.

Program	Contact	Service
Department of Aging	(866) 468-7887	Iowa's Department of Aging serves as an entry point for seniors and their families looking into long-term care and other helpful information relating to aging in the state. The state's website links to Iowa's six Area Agencies on Aging, where trained counselors can provide information, assistance and referrals for seniors in their coverage areas.
BenefitsCheckUp	(800) 794-6559	BenefitsCheckUp is a free resource operated jointly by the National Council on Aging and the Iowa Department of Aging. This online service compiles the available health care options for seniors based on their answers to a short series of questions. The list of results provides links to the services that may be available, such as TRICARE for Life and Medicare Savings Programs. Families can call a helpline if they have additional questions regarding Medicare availability.
Medicare.gov	(800) 633-4227	Medicare.gov is a federal website with information about Medicare that families and seniors can access for free. It provides general information about the health care program, in addition to state-specific content and links to useful websites and phone numbers. Its live chat function operates 24/7 so visitors can ask questions of trained advisers, who can call visitors back if a chat is interrupted.

Other Financial Assistance Options for Nursing Home Care in Iowa

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

Name	How To Apply	How It Works
Aid and Attendance	Learn more and apply online at va.gov.	Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.
Reverse Mortgages	Learn more about your options and how to apply at ftc.gov	If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) Insurance	Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.	Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Iowa

The state of Iowa has many resources available to seniors to help them and their families make the right choices about long-term care. These resources also protect vulnerable seniors from abuse and neglect. If you are considering nursing home care for your senior loved one, make sure you take full advantage of the resources available to you.

Resource	Contact	Service
Veterans Affairs Long-Term Care	(877) 222-8387	Honorably discharged veterans in Iowa may be able to get help finding nursing home services through VA health care. The VA operates several community living centers around the state, and many more privately operated facilities are under contract with the department. Depending on the veteran's eligibility, the VA may be able to pay some or all of the cost of long-term care.
Home Health Services (HHS)	(800) 338-8366	Home Health Services is a program that can help seniors in Iowa stay out of skilled nursing placement and remain in their own homes with the assistance of trained caregivers. With a physician's approval, eligible Medicare beneficiaries may be able to get skilled nursing and caregiver assistance, home health visits and therapy services at a reduced cost or for free.
Return to Community	(800) 432-9209	Seniors in Iowa can get assistance leaving nursing care through the Return to Community program. Return to Community helps returning seniors with transitional care and other services geared toward promoting a safe return home. Participants in the Return to Community program must be Iowans aged 60 and over, not currently on Medicaid and able to safely return to their own home from a residential care facility.
Iowa Respite Care	(800) 468-7887	The Iowa Department on Aging offers free resources on respite care for caregivers and family members looking after a senior loved one in the state. Education, training and short-term respite are available through the state's Area Agencies on Aging.
Senior Supportive Services	(800)779-8707	Iowa's Senior Supportive Services helps seniors and their families remain active in their communities with senior care options counseling, placement assistance, case management and independence-oriented transportation assistance. Limited support is available for the in-home caregiver, and behavioral support is offered for seniors with mental health or cognitive issues.
Iowa Long-Term Care Ombudsman Program	(866) 236-1430	In Iowa, the Office of the State Long-Term Care Ombudsman is charged with advocating for the rights and wishes of residents and tenants who live in nursing homes, assisted living programs, residential care facilities and elder group homes. All services provided are confidential and free of charge.

Nursing Home Laws and Regulations in Iowa

Topic	Rule
Licensing Requirements	Nursing homes in Iowa receive their licenses from the Iowa Department of Inspections and Appeals. Licenses are good for one year after issuance. Iowa nursing home regulations state that licensed nursing homes must apply for renewal at least 30 days prior to the license expiring.
Staffing Requirements	Iowa law requires that the facility have enough staff to meet the requirements of individual licenses. This includes both licensed nurses and direct care staff.Staff must include enough care personnel for each resident to receive two hours of care per day, and 20% of this care time must be from licensed nursing staff. If the facility has 75 or more beds, a licensed nurse must be on staff 24/7
Staff Training Requirements	SNFs must have organized, ongoing in-service to educate and train personnel on proper resident care. All nurse's aides and similar care professionals must complete a 75-hour nurse’s aide program prior to employment or a 20-hour on-the-job training program that is approved by the state.
Admission Restrictions	Iowa nursing homes can only admit residents who need care the facilities are qualified to provide. Facilities can only admit as many residents as they have licensed beds to care for.
Care Planning Requirements	All SNFs must provide individual care plans for each resident in their care. The care plan is based on treatment decisions from each resident's physician, the illness or disability the resident has, and any care prescribed by the physician. These must be put into writing, revised when needed, and offered to all care providers who provide care to the resident.
Dietary and Nutritional Services Requirements	At each facility, a registered dietitian must serve as dietary supervisor. Each resident's nutritional needs must be considered when planning meals and menus. Meals must cover 100% of the daily recommended dietary allowances, and accommodations for dietary concerns of residents must be made. All menus should be published in writing at least one week in advance.
Specialized Rehabilitative Services	Facilities should plan for rehabilitative services that help residents maintain function and carry out activities of daily living. They must have a written agreement with a licensed physical therapist and arrangements for specialized and supportive rehab services when required by a physician.Specialized rehab should include audiology and occupational therapy either on-site or at another location, with transportation provided from the nursing home to the therapy center.
Medication and Pharmaceutical Services	SNFs must administer medications as ordered by the physician. Only nurses are allowed to administer any injectable medication. Medications must be stored in a cabinet with a lock, labeled properly with each patient’s name on their medications. Only care providers who have been trained in medication administration through a department-approved medication course can administer medication.
Activities Requirements	Organized activities for both daytime and evening hours are required. The activities need to meet the needs and interests of the residents and be something residents can participate in even with physical restrictions. Group and individual activities should be part of the plan.
Infection Control Requirements	A written infection control plan is required for each SNF in the state. The policies should follow recommendations from the DCD and the U.S. Department of Health. The infection control plan must include the establishment of an infection control committee.
Medicaid Coverage	Iowa Medicaid pays for all or a portion of nursing home care for many residents. To qualify for Medicaid coverage for nursing home care, residents must meet income and asset guidelines set forth by the state.