Elderly who decide to make Iowa their home will find the state to be reasonably tax-friendly. Those with a social security income do not have to pay state taxes. Additionally, any public and private pension income are only partially taxed and prescription drugs are exempt from sales tax.
Paying For Assisted Living in Iowa
The Cost of Assisted Living in Iowa
The monthly median cost of assisted living in Iowa is $3,847, which is cheaper than the national average of $4,000. According to Genworth’s 2018 Cost of Care Survey, assisted living in Iowa is also less expensive than the median in all but three neighboring states, Missouri, Nebraska, and South Dakota.
While the cost of Assisted Living is fairly consistent throughout the state, Sioux City is the one exception coming in at $797 below the state average. The Philadelphia Area is the most expensive region in the state at $175 above the national average of $4,000.
While nursing home care is relatively cheap in Iowa when compared to the rest of the nation, it’s still considerably more expensive than assisted living. Other than independent living, which doesn’t provide assistance with activities of daily living, assisted living communities are the cheapest solution for long-term care in the state.
Financial Assistance for Assisted Living in Iowa
Iowa Elderly Waiver Program
Medicaid does not cover assisted living in Iowa, however, they offer waiver programs, referred to as Home and Community Based Services (HCBS). Not all facilities in Iowa accept the waivers, so keep this in mind as you search for an assisted living facility for you or your elderly loved one.
The Elderly Waiver covers nursing and skilled levels of care based on a resident’s needs. An interdisciplinary team (IDT) consisting of the resident, case manager, Managed Care Organization, community-based case manager, service providers, and other persons the resident chooses will determine what services are appropriate. During this time, a service plan will be developed. Service plans may include attendant care from an assisted living provider or anyone else the resident chooses, nursing care, nutritional counseling, or other tasks.
Since this waiver isn’t an entitlement program, even if you do qualify, you may not be accepted if the enrollment cap is reached. Instead, you will likely be placed on a waiting list. If you are eligible and accepted into the program, there are also service cost limits:
- Nursing level of care services cannot exceed $1,339 per month.
- Skilled level of care services cannot exceed $2,765 per month.
Who Is Eligible?
Residents interested in applying for the Elderly Waiver need to qualify for Medicaid as well as meet certain income, asset limits, and functionality requirements. If you’re 65 years of age or older, the qualifications for Medicaid include:
- You must need nursing or skilled level of care, which is determined annually by the Iowa Medicaid Enterprise and Medical Services Unit.
- You must be a legal U.S. citizen (or a person with legal entry) who lives in Iowa.
- The monthly income for a single resident must not exceed $2,250 (in 2018), and assets must be $2,000 or less.
- The monthly income for married residents must not exceed $4,500 (in 2018), and assets must be $3,000 or less.
How to Apply
To get more details about eligibility requirements and to start an application, contact your local Department of Human Services (DHS) office. You may also call (800) 338-8366 or (515) 256-4606 (Des Moines Area) and let them know you’d like to apply for the Elderly Waiver.
More Ways to Finance Assisted Living
Some additional ways to finance assisted living costs include:
- Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.
- Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov.
- Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.
- Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.
Free Assisted Living Resources in Iowa
Long-Term Care Ombudsman Program
The federal Older Americans Act requires all states to have an Ombudsman Long-Term Care Ombudsman Program. In Iowa, the Ombudsman Program focuses on ensuring the elderly receive proper care. Their services include:
- Educating elderly residents, their families, long-term care facility staff, and the community about residents’ rights
- Advocating for residents’ rights as well as their need to receive proper care and treatment in long-term care facilities
- Investigating and resolving complaints about legal issues, discharge concerns, elderly abuse, or other matters against facilities
- Encouraging Iowa citizens to get involved with the Ombudsman Program by offering volunteer opportunities
To contact the Iowa Ombudsman Program, call (515) 281-3592.
Area Agencies on Aging
Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across America that provide federally funded services to adults over 60 in their local areas.
Iowa has many Area Agencies on Aging that offer comprehensive information on various kinds of programs and community supports for seniors.
|Area Agency on Aging||Address||Phone Number|
5835 Grand Avenue Ste. 106, Des Moines, IA 50312
(515) 255-1310 or (800) 747-5352
300 West Broadway Ste. 240, Council Bluffs, IA 51503
(712) 328-2540 or (800) 432-9209
22 North Georgia Ste. 216, Mason City, IA 50401-3435
(641) 424-0678 or (800) 243-0678
623 Pennsylvania Ave., Ottumwa, IA 52501
(641) 682-2270 or (855) 410-6222
2101 Kimball Ave. Ste. 320, Waterloo, IA 50702
(319) 874-6840 or (800) 779-8707
6301 Kirkwood Blvd. SW, Cedar Rapids, IA 52406
(319) 398-5559 or (800) 332-5934
Veterans and their spouses can get assistance from their local VA offices with transportation, financing, and various other services. Visit or contact a center near you for guidance on the best support options and eligibility for you or your elderly loved one.
|VA Office||Address||Phone Number|
180 Public Square, Greenfield, Iowa 50849
500 Ninth Street, Corning, IA 50841
110 Allamakee St., Waukon, Iowa 52172
19999 St. Joseph Drive, Centerville, IA 52544
318 Leroy St. #4, Audubon, IA 50025
303 1st Avenue, Vinton, IA 52349
1407 Independence Avenue 1st Floor, Waterloo, IA 50703
201 State St., Boone, IA 50036
(515) 433-4904 or (800) 753-2136 (ext. 234)
203 1st Ave NE, Waverly, IA 50677
210 5th Ave NE, Independence, IA 50644
1709 E Richland St., Storm Lake, IA 50588
(712) 749-2562 or (866) 844-8150
428 Sixth St., Allison, IA 50602
515 Court St., Rockwell City, IA 50579
(712) 297-8632 (ext. 227)
608 North Court St., Ste. A, Carroll, IA 51401
5 West 7th St., Atlantic, IA 50022
400 Cedar St., Tipton, IA 52772
220 North Washington Ave., Mason City, IA 50401
520 W. Main St., Cherokee, IA 51012
910 East Main St., New Hampton, IA 50659
100 Main St., Osceola, IA 50213
337 Tenth St., SW, Spencer IA 51301
600 NE Gunder Road Suite 6, Elkader, IA 52043
1900 N 3rd St., Clinton IA 52733
1202 Broadway, Dension, IA 51442
902 Court St., Adel, IA 50003
203 South Madison St., Bloomfield, IA 52537
207 North Main St. 1st Floor, Leon, IA 50144
601 Grant St., Manchester, IA 52057
910 Cottonwood, Ste. 1001, Burlington, IA 52601
1802 Hill Ave Ste. 1508, Spirit Lake, IA 51360
36 East 8th St., Dubuque, IA 52001
609 1st Avenue North Suite #5, Estherville, IA 51334
102 South Frederick Ave #1, Oelwein IA 50662
101 South Main St. #109, Charles City, IA 50616
12 – 1st Ave. NW, Hampton, IA 50441
414 Clay St., Sidney, IA 51652
114 N. Chestnut St., Jefferson, IA 50129
706 H Ave, Grundy Center, IA 50638
200 North 5th St., Guthrie Center, IA 50115
500 Fairmeadow Drive, Webster City, IA 50595
545 State St., Garner, IA 50438
1201 14th Ave., Eldora, IA 50627
207 E 7th St., Logan, IA 51546
106 N. Jackson St., Ste. 1, Mt. Pleasant, IA 52641
137 North Elm St. Cresco IA 52136
P.O. Box 331, Humboldt, IA 50548
401 Moorehead St., Ida Grove, IA 51445
970 Court Ave, Marengo, IA 52301
201 West Platt St., Maquoketa, IA 52060
115 North 2nd Avenue E 1st Floor, Newton, IA 50208
51 West Briggs Avenue # 3, Fairfield, IA 52556
855 South Dubuque St, Ste. 109, Iowa City, IA 52240
105 Broadway Place, Ste. 13, Anamosa, IA 52205
101 South Main, Sigourney, Iowa 52591
109 West State St., Algona, IA 50511
701 Avenue F, Fort Madison, IA 52627
1240 26th Avenue Court SW, Cedar Rapids, IA 52404
503 Franklin Street Ste. 2 Wapello, IA 52653
123 S. Grand St., Chariton, IA 50049
300 South 4th Avenue, Ste. 100 Rock Rapids, IA 51246
112 North John Wayne Dr., Winterset, IA 50273
301 1st Avenue East, Oskaloosa, Iowa 52577
214 East Main St., Knoxville Iowa 50138
1301 Veterans Blvd, Iowa Veterans Home, Heinz Hall, Room 45,
Marshalltown, IA 50158
602 S Locust St., Glenwood, IA 51534
212 South 5th St., Osage, IA 50461
610 Iowa Avenue 3rd Floor, Onawa, IA 51040
1801 South B St., Albia, IA 52531
105 East Coolbaugh St., Red Oak, IA 51566
315 Iowa Ave. Ste. 1, Muscatine, Iowa 52761
155 South Hayes Ave, Primghar, IA 51245
300 7th St., Sibley, IA 51249
615 NW Road, Shenandoah, IA 51601
(712) 246-4254 or (712) 215-9030
1010 Broadway, Emmetsburg, IA
215 4th AVE SE, Le Mars, IA 51031
23 3rd Ave NE, Pocahontas, IA 50574
2309 Euclid Avenue, Des Moines, IA 50310
623 6th Avenue, Council Bluffs, IA 51501
200 4th Avenue West (Lower Level), Grinnell, IA 50112
109 West Madison, Mount Ayr, IA 50854
100 NW State St. Box 5, Sac City, IA 50583
600 West 4th St., Davenport, Iowa 52801
612 Court St., Harlan, IA 51537
P.O. Box 233, Orange City, IA 51041
126 S. Kellogg Avenue Ste. 001, Ames, IA 50010
219 West High St., Toledo, IA 52342
305 Main St., Bedford, IA 50833
300 North Pine Street Suite #180 (Lower Level), Creston, Iowa 50801
406 Dodge St., Keosauqua, IA 52565
114 E. Main St., Ottumwa, IA 52501
105 West 1st Ave., Indianola, IA 50125
2175 Lexington Blvd., Washington, IA 52353
100 N. Lafayette Courthouse – Room #103, Corydon, IA 5006
723 1st Ave S, Fort Dodge, IA 50501
216 South 4th St., Forest City, IA 50436
201 W. Main St., Decorah, IA 52101
1211 Tri View Ave, Sioux City, IA 51103
(712) 279-6605 or 6606
99B 9th ST. N, Northwood, IA 50459
120 1st Ave NW Ste. 3, Clarion, IA 50525
Social Security Offices
By reaching out or visiting a Social Security office, you or your elderly loved one can gain a better understanding of social security benefits as well as other types of assistance that can help with assisted living costs.
|Social Security Office||Address||Phone Number|
2615 University Blvd., Ames IA 50010
3920 Division St., Burlington IA 52601
818 North Bella Vista Dr., Carroll IA 51401
Cedar Rapids Office
3165 Williams Blvd Sw, Cedar Rapids IA 52404
4319 North Brady St., Davenport IA 52806
Council Bluffs Office
20 Arena Way Ste. 1, Council Bluffs IA 51501
906 East Taylor St., Creston IA 50801
Des Moines Office
455 Sw 5th St. Ste. F, Des Moines IA 50309
1635 Associates Dr., Dubuque IA 52002
Fort Dodge Office
2315 2nd Ave North, Fort Dodge IA 50501
1100 6th St., Coralville IA 52241
2502 South 2nd St., Marshalltown IA 50158
Mason City Office
625 Village Grn Dr. Sw, Mason City IA 50401
2429 Northgate St., Ottumwa IA 52501
Sioux City Office
3555 Southern Hills Dr., Sioux City IA 51106
1610 12th Ave Sw, Spencer IA 51301
3121 Greyhound Dr., Waterloo IA 50701
Assisted Living Laws and Regulations in Iowa
Assisted Living Occupancy Agreement
When accepted into an assisted living facility, a written occupancy agreement is required. Make sure the agreement includes:
- All of the facilities’ fees, charges, and rates for rent and services
- The services the resident will receive and a description of those services
- Any third party payments they will accept from the resident (e.g. Medicaid)
- Their policy on what they do if the resident’s financial assistance runs out
- How long the occupancy agreement is in effect and instructions on how it can be terminated
- Procedures for involuntary transfer in regards to the resident’s health or for other reasons
- How the resident can file an appeal or grievance if the need to do so arises
- The assisted living facilities rules in regards to billing and payment, as well as their refund policy
The facility must give the resident or the resident’s legal representative a copy of the occupancy and all the documents and attachments. If changes are made in the agreement, the assisted living facility (ALF) is required to provide the resident or his or her representative with a written copy of the changes within 30 days before the changes, unless the following occurs:
- The resident’s health or behavior causes him or her to become a health or safety threat to self or others.
- An emergency or significant change in the resident’s condition results in the need for services not already in the resident’s occupancy agreement.
- The assisted living facility is unable to provide the necessary services.
Assisted Living Admission Requirements
In order to determine if an assisted living facility in Iowa can provide the level of care you or your elderly loved one needs, he or she must receive an evaluation of their functional, cognitive, and health status.
If the resident is terminally ill, he or she is allowed to receive hospice services from a Medicaid-certified hospice program.
Assisted living facilities in Iowa are not allowed to admit a resident who:
- Is in need of more than part-time or intermittent health-related services
- Is bed-bound
- Requires more than two people to assist with standing, transferring or evacuating
- Regularly has uncontrollable incontinence
- Is a danger to self or others
- Has an acute stage of alcoholism, drug addiction, or uncontrolled mental illness
- Is medically unstable or needs maximum assistance with activities of daily living
Assisted Living Scope of Care
Assisted living facilities must include the services they provide to each resident in the occupancy agreement. Services offered in Iowa include activities that support the resident’s service plan, health-related care, personal care, and assistance with instrumental activities of daily living (e.g. chores, cooking, housekeeping, shopping, and traveling in the community).
Assisted Living Medicaid Policy
As in most states, Iowa Medicaid covers the cost of nursing home care but not assisted living. They do, however, offer the Elderly Waiver, which helps Iowa seniors with the cost of home and support services provided by assisted living facilities who accept the waiver.
The Elderly Waiver does not cover the cost of room and board. Additionally, even if you or your loved one qualifies for the Elderly Waiver, receiving care is not guaranteed as there is also waiting list. As of November 2018, there are no applicants on the list, but that can change at any time.
Assisted Living Facility Requirements
The Iowa Department of Inspections and Appeals certifies assisted living facilities in Iowa. They are also responsible for making sure the facilities follow all the rules and regulations. Some of the rules and regulations for Iowa facilities include:
- There must always be at least one qualified employee at the facility and awake to assist and monitor residents.
- Private units must have single-action locks on the entrance doors unless it endangers the resident’s health or safety.
- Units are required to have bathrooms with a working toilet, sink, and other bathing facilities unless the assisted living facility houses dementia residents.
Medication Management Regulations
A resident can administer their own medication or request a qualified employee at the facility to give him or her the medicine. Only a registered nurse, licensed practical nurse, advanced registered nurse practitioner, or medication aide who has received instructions from a licensed professional nurse is allowed to administer medication to residents who need an assistance.
Assisted living facilities in Iowa must always have at least one qualified employee at the facility. All employees must be awake to assist and monitor residents.
Staff Training Requirements
Licensed professional nurses are required to complete six or more hours of assisted living or nursing class related to Iowa assisted living rules and laws.
Anyone who works in an assisted living facility in Iowa that provides care to residents with dementia must have a minimum of eight hours of education and training related to dementia. In addition, the staff is required to continue receiving at least two hours of dementia-related education each year.
Contracted staff who do not have contact with residents are exempt from the dementia-related education and training requirement.
Background Checks for Assisted Living
Prior to employment, the assisted living facility is required to request a criminal history check by the Department of Public Safety and a child and dependent adult abuse record check by the Department of Human Services. If it’s determined that the applicant has a record, the decision to hire the applicant will be left up to the Department of Human Services.
Requirements for Reporting Abuse
If you suspect an assisted living facility or any of its employees abusing your elderly loved and/or not following the rules and regulations, or if you are the one being abused or neglected, contact the Iowa Department of Inspections and Appeals at (877) 686-0027 or Ombudsman at (866) 236-1430.
If you or your elderly loved one is being neglected or abused physically, sexually, or through exploitation by anyone, the Dependent Adult Protective Services (APS) handles these reports. You can contact APS toll-free, 24 hours a day, 7 days a week at (800) 362-2178.