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.




The United States






South Dakota







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.






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Des Moines

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.


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Adult day care


Assisted living


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Home health care

Financial Assistance for Nursing Home Care in Iowa

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. However, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Iowa.

Iowa’s Medicaid Program

In September of 2020, Iowa had 724,000 people enrolled in Medicaid and CHIP, including many seniors using the program to pay for long-term care, including nursing home care, home health care and assisted living. Over 55,000 Iowa seniors currently receive care in a nursing home, and the state has 430 homes available to help seniors with their long-term care needs. 

In Iowa, Medicaid is broken down into different programs based on income and medical needs. For families looking at nursing home care for seniors or disabled loved ones, the Institutional/Nursing Home Medicaid program can fit well. Through this program, income-eligible seniors with a medical need can get their nursing home care paid for through Medicaid. The state also offers a Medicaid Waiver called Home and Community Based Services. Through this program, you may be able to get Medicaid to cover at-home care rather than nursing home care. HCBS only takes on a limited number of participants.

Medicaid Eligibility in Iowa

Iowa Medicaid is available to seniors age 65 and older who make less than 300% of the federal poverty level. In 2021, that amount is $2,382 a month. In addition, seniors must have no more than $2,000 in non-exempt assets. In addition, the person’s total gross income cannot exceed 125% of the statewide average cost for the type of care necessary. In addition, applicants must be Iowa residents and U.S. citizens or legal immigrants. A senior also must have a physician’s documentation of the need for nursing home care. You can apply through the Medicaid website.

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not 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.

ResourceContact Service
Area Agencies on Aging(800) 532-3213Area Agencies on Aging provide a contact point for older Iowa residents to access the services that are available in their communities. AAAs have case managers who help seniors and their families find community support, access coverage to pay for nursing home care, and research long-term care programs. Many AAAs offer transportation services for seniors who need help getting around the community.
Iowa Long-Term Care Ombudsman(515) 725-3308The Iowa Long-Term Care Ombudsman Program provides advocacy services for seniors in the state who live in nursing homes and other long-term care facilities. The ombudsman investigates any complaints related to abuse and neglect in these facilities. It also helps families get the help they need to fight for the rights of their loved ones in long-term care facilities.
Iowa Department of Aging Legal Assistance Program(515) 282-8161Adults age 60 and older can receive legal advice and representation through the state’s Legal Assistance Program. This program, offered through the AAAs, contracts with lawyers and other legal service providers to offer free or low-cost legal help to seniors. It also offers a legal hotline for immediate help for older Iowans.
Iowa Department of Veterans Affairs(515) 252-1824Through the DAV, Iowans who are qualified U.S. veterans can access help they earned through their military service. This can include health care through DAV facilities, military retirement benefits, and benefits for spouses and dependents.
Alzheimer’s Association Greater Iowa Chapter(515) 440-2722The Iowa Chapter of the Alzheimer’s Association advocates for seniors with dementia and their families. It provides access to support groups and local resources to assist families affected by this disease. The Alzheimer’s Association also offers community education services and consults with families about care options when they have a loved one with Alzheimer’s disease.
Iowa Senior Health Insurance Information Program(800) 633-4227Trained Medicare counselors offer counseling services through SHIIP in most counties in Iowa. This counseling helps seniors and their families choose the right Medicare program to help with medical and long-term care costs. One-on-one counseling takes into consideration each individual’s medical and financial needs. This service is provided free of charge.

Nursing Home Laws and Regulations in Iowa

Licensing RequirementsNursing 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 RequirementsIowa 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 RequirementsSNFs 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 RestrictionsIowa 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 RequirementsAll 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 RequirementsAt 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 ServicesFacilities 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 ServicesSNFs 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 CoverageIowa 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.

Nursing Homes Facilities in Iowa (85)