Assisted Living in Iowa

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.

Directory of Assisted Living Facilities in Iowa

When beginning the hunt to locate a quality assisted living facility in Iowa, it’s essential to think about the services they provide and what programs are available to help pay for those care services. The registry below can aid you in your search by providing details and information on more than 150 facilities in the state of Iowa.

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.

Veterans Affairs

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.

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.

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.

Staffing Requirements

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.

Iowa COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/8/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in Iowa
Are loved ones allowed to visit residents in their assisted living community?	Yes (Conditions Apply)
Are residents required to quarantine after their loved ones visit?	No
Are loved ones required to wear masks when visiting residents?	Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities?	Yes
Are visitors screened for elevated temperatures before entering the assisted living community?	Yes
Are residents allowed to leave the assisted living community for non-medical reasons?	Yes
Are residents who leave required to quarantine when they get back to the assisted living community?	No (Conditions Apply)
Are assisted living communities required to cancel all group outings?	No
Are assisted living communities allowed to host group activities within the community?	Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures?	Yes
Are staff members regularly tested for COVID-19?	Yes (Conditions Apply)
Are residents regularly screened for COVID-19 symptoms?	Yes
Are residents regularly checked for elevated temperatures?	Yes
Are residents regularly tested for COVID-19?	Yes (Conditions Apply)

Sources: iowaaging.gov www.cdc.gov