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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.
Find Options Near You
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 $32,904 a year and possess countable assets of $2,000 or less. A married couple applying for Medicaid together must earn less than $65,808 and have assets worth no more than $3,000, while a married couple where only one partner applies has an income limit of $2,742 a month and asset limits of less than $2,000 for the applicant and $148,620 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.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808 | $3,000**** |
*All monthly income except for a $50 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****After six months of Medicaid eligibility, the rules for married couples change. They can then can choose to be considered as single applicants, which would change the asset limit to $2,000 each spouse.
In addition to the financial and medical need criteria, Medicaid in Iowa has other requirements, including:
- 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.
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
There are many resources in Iowa that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Department on Aging | 866-468-7887 | Across Iowa, six Area Agencies on Aging provide supportive services for older adults to improve their overall quality of life. These agencies can connect seniors with local transportation services, nutritional programs, community support groups and other local aid. Additionally, low-income seniors can benefit from a variety of cost-saving programs, including home weatherization, heating and cooling bill support and help paying for medical care. AAAs also advocate for senior wellness by intervening in suspected cases of Medicare fraud or abuse. |
Cash Assistance Programs
Cash assistance programs in Iowa provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, Iowa seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Home and Community-Based Services (HCBS) Elderly Waiver | 800-338-8366 | Seniors requiring nursing home care and can safely remain in their own homes, or in an assisted living community, can apply for the Home and Community-Based Services (HCBS) Elderly Waiver. The level of financial assistance provided is decided on an individual basis. Beneficiaries take an annual assessment that determines the required coverage and level of services. Coverage may include assistance with paying the costs associated with assisted living, adult day care, home health aides, emergency response systems and home-delivered meals. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Iowa seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Department on Aging Meal Services | 866-468-7887 | The Iowa Department on Aging provides comprehensive meal services and nutrition resources for senior citizens in Iowa — focusing on health, well-being and socialization. Services include meal programs for those aged 60 or older, nutrition counseling with registered dietitians and nutritional education resources. It partners with local food establishments through The Iowa Cafe program to offer services more efficiently. |
| Iowa Meals on Wheels | Iowa Meals on Wheels offers hot, home-delivered meals to seniors aged 60 and older and military veterans of all ages. Eligible seniors must have difficulty shopping or preparing food on their own. Volunteers deliver nutritious, ready-to-eat meals Monday through Friday, with three menu options available. Seniors who meet income eligibility guidelines qualify for free meals. Otherwise, meals are available for purchase. | |
| Iowa Supplemental Nutrition Assistance Program (SNAP) | 800-972-2017 | The Iowa Supplemental Nutrition Program offers food benefits for individuals who need additional funds to purchase food. Many seniors in the state qualify for SNAP, and they can apply online through the Health and Human Services website. Through SNAP, seniors can supplement their food budgets to add more healthy foods to their diets. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Iowa collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Habitat for Humanity Quad Cities | 563-349-7339 | Habitat for Humanity Quad Cities sells donated medical equipment at affordable prices. All equipment is new or lightly used and inspected for safety. |
| Iowa Easterseals | 866-866-8782 | DME is loaned for a nominal charge and can be used for any length of time. The organization also manages the Iowa Assistive Technology Exchange Program. The website connects seniors with providers across Iowa who have equipment available for loan or sale. |
| Iowa Exceptional Persons, Inc. | 319-232-6671 | EPI offers free loans on a variety of used medical equipment to seniors. Equipment, such as crutches, walkers, bath chairs and commodes, can be borrowed for any length of time. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Iowa have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Rural Development State Office | 515-284-4663 | The program provides grants of up to $10,000 which older adults can use to remove health and safety hazards from their property. Seniors can visit the U.S. Department of Agriculture website to check if their home is eligible for the program. |
Legal Resources
Many organizations offer free or low-cost legal services to Iowa seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Long-Term Care Ombudsman Program | The Long-Term Care Ombudsman program protects seniors against abuse and neglect in assisted living and other care facilities. Seniors can reach out to request intervention if they suspect abuse. The ombudsman works with the senior and the facility to resolve the concern and ensure adequate care. | |
| Iowa Office of the Public Guardian | 515-725-3333 | Iowa seniors who can't make their own legal, financial or health care decisions may be assisted by a guardian through the Office of the Public Guardian. To qualify for these services, a senior must be unable to pay for a substitute decision-maker, and/or have no suitable relative or other responsible individual who can act on their behalf. |
| Iowa Office of the State Long-Term Care Ombudsman | 641-420-9850 | The Long-Term Care Ombudsman is an advocate for the rights of seniors in residential care communities. Financed by the state, the ombudsman doesn't charge for its services, which include investigating complaints about facilities by their residents, or their families, and third parties. The ombudsman pursues solutions with care providers on behalf of residents and doesn't charge for any of its services. Additional services include providing copies of inspection reports to families comparing memory care communities for their loved ones. |
Senior Centers
Senior centers in Iowa bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa 211 | An initiative of the United Way, 211 Iowa is an information and referral service that can help connect seniors and caregivers with resources in their communities. Individuals can call the organization to speak with trained experts who can provide information and help direct them to services that suit their individual needs and circumstances. The service is free, confidential and available 24/7. | |
| Iowa Care Planning Council | 800-989-8137 | The Iowa Care Planning Council is organized by the National Care Planning Council, a nationwide nonprofit organization that provides comprehensive information on issues that affect older adults. Through this resource, seniors can find information on paying for memory care services, including taking out reverse mortgage loans, applying for veterans' benefits and purchasing long-term care insurance. The council also has an updated list of memory care facilities in Iowa. |
Senior Engagement
Senior engagement resources and programs in Iowa help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Alzheimer's Association Greater Iowa Chapter | 515-440-2722 | The Greater Iowa Chapter of the Alzheimer's Association provides localized support for seniors dealing with cognitive decline and families caring for those with dementia. Help comes in several forms, such as support groups facilitated by trained association members that enable seniors with Alzheimer's to converse with others with the condition and for caregivers to build collective strength with other Waterloo residents caring for their loved ones. There are also care consultations, where counselors help seniors and their families develop road maps for care that prepare for a life with Alzheimer's. |
Social Security Offices
Social Security offices in Iowa help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Iowa resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Homestead Tax Credit and Exemption | 800-367-3388 | Homeowners aged 65 and older who meet certain financial criteria can make a claim for tax relief under the state's Homestead tax laws. Iowa seniors who live in rental properties could be entitled to rent reimbursement. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Iowa retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa Low Income Home Energy Assistance Program (LIHEAP) | 515-242-5655 | The Low Income Home Energy Assistance Program (LIHEAP) helps low-income seniors pay their home energy bills. This federally-funded program provides a one-off payment toward a resident's residential heating utility. |
Veteran's Services
Iowa retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Iowa VA Benefits and Health Care | Iowa VA Benefits and Health Care helps ensure Iowa's senior veterans receive the care and benefits they've earned. With services ranging from health care and pension programs to disability benefits and housing assistance, veterans' needs are catered to accordingly. For veterans to be eligible for these programs, they need appropriate service records and Iowa residency requirements. To further show its commitment to Iowa's senior veterans, the organization offers dignified burials. |
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. |
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