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Guide to Senior Living in Iowa

Seniors in Iowa make up 17.1% of the population – a slightly higher proportion compared to the nation – and this has increased by over 2% in the last decade. The state’s low population density and high scores on important health metrics may be contributing to the longevity of its residents. Iowa has a higher air quality rating than surrounding states and the country as a whole, which significantly reduces the risk of respiratory illness and cancer, and its water quality index is also above average.

Many Iowans will require residential care at some point, and there are an increasing number of facilities available to provide it. Iowa is moderately priced in terms of senior living. For example, assisted living, with a monthly average cost of $4,078 is close to the United States average of $4,051, according to the Genworth Cost of Care Survey 2019.

This guide is intended to help seniors in Iowa discover the costs of senior living and other long-term care in the state. It also covers financial assistance programs, facility regulations and common questions.

Covid-19 Rules and Restrictions for Iowa Senior Living Facilities

The following rules and guidelines were obtained from the Iowa Department of Public Health website, as well as other state-level government sites. Among others, these rules apply to nursing homes and assisted living (assisted living facilities are allowed to adjust restrictions significantly).

This data has been most recently updated on 7/19/20, but keep in mind that COVID-19 is a rapidly evolving crisis, so all of the below information can change at any time. For additional questions and up-to-date information, you can contact your loved one’s senior living facility or your local Area Agency on Aging

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?Yes (varies by facility)
Can I visit my relative in person for end-of-life compassion care?Yes 
Will my loved one be required to self-quarantine after I visit him or her?Yes (varies by facility)
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Yes
Are hairdressers and other non-medical contractors still allowed in senior living facilities?Yes (varies by facility)
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?Yes
Are visitors being screened for elevated temperatures?Yes
Are visitors being asked questions about health, travel, and potential virus contact?Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?Yes, but it is strongly discouraged
Are residents of senior living facilities who leave and return required to self-quarantine?Yes
Are senior living facilities required to cancel all group outings?Yes
Are residents still eating together in the dining hall?Yes, with social distancing
Are facilities still allowed to host group activities within the community?Yes, with social distancing

Safety Measures for Staff & Contractors 

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus?Yes (availability of testing varies)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents 

Are staff members required to regularly screen residents for coronavirus symptoms?Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?No
Are staff members required to take residents’ temperatures?Yes
Are residents being tested for coronavirus?Yes (availability of testing varies)

Paying for Senior Living in Iowa

One of the most common decisions facing seniors and their family members is between assisted living and in-home care. The difference in cost is quite high in Iowa, where it costs almost $700 more per month for in-home care compared to assisted living. Adult day care is relatively affordable and the cheapest option by far at $1,376 per month, although it’s not an alternative to assisted living in most cases. The average cost of a semi-private room in a nursing facility is $6,342, and the option of a private room adds approximately $500 more to the bill.


Assisted Living


In-Home Care


Home Health Care


Adult Day Care


Nursing Home Care

The Cost of Assisted Living in Iowa

Seniors in Iowa pay an average of $4,078 per month for assisted living, which is very similar to the national average of $4,051. In comparison to nearby states, assisted living in Iowa is relatively affordable. Wisconsin is more expensive, with an average cost of $4,350 per month, and in Illinois the cost is just slightly higher than the state at $4,170. The cost is lower in Minnesota and Nebraska, with monthly averages of $3,800 and $3,819, respectively.




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The Cost of In-Home Care in Iowa

Seniors who require minimal help with daily tasks may choose to continue living in their own home and opt for in-home care as opposed to assisted living. In Iowa, in-home care incurs a monthly cost of $4,767, which is $477 above the national average of $4,290. This is still better than northern neighbor Minnesota where seniors pay $5,529 a month for in-home services. To the northeast, Wisconsin matches the fee in Iowa and to the west and east of Iowa, Nebraska and Illinois are slightly less expensive with monthly rates of $4,671 and $4,481, respectively. 




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The Cost of Nursing Home Care in Iowa

Iowa’s cost of nursing home care falls well below the national average of $7,513 with a monthly rate of $6,342. This rate is one of the best around as compared to neighboring states Minnesota, Wisconsin and Nebraska, where monthly fees come to $10,076, $8,273 and $7,003, respectively. Budget conscientious seniors who want to pay less for nursing home care and are willing to move to Illinois can receive the same care for $5,931 a month, a savings of over $400 a month. 




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Financial Assistance for Senior Living in Iowa

Iowa Medicaid HCBS Elderly Waiver

Medicaid provides health coverage based on income, age and other factors. The majority of Medicaid members aged 65 and older in Iowa are in the IA Health Link managed care program. Members have access to many services, such as prescription drug coverage, in-home and hospital care, as well as vision and dental.

Additional funding and support is available to eligible members via the Home and Community-Based Services Elderly Waiver. The HCBS Elderly Waiver provides a tailored set of services based on financial and health factors, with the exact amount of coverage determined through annual assessments. Personal care received in a senior living facility may be covered if it’s considered cost-effective to the state.

Applicants for HCBS Elderly Waiver services must be a legal resident of Iowa aged 65 or older. They must also be eligible for Medicaid and assessed as requiring a nursing or skilled nursing level of care. There is a monthly income limit equal to 300% of the federal benefit rate, which is $2,349 as of 2020, and a limit of $2,000 in countable assets.

Contact: Visit the DHS Services Portal to check eligibility and apply for assistance online, in person or through the mail. Call Iowa Medicaid Member Services at (800) 338-8366 for more information.

State Supplementary Assistance (SSA)

The Iowa Department of Human Services helps eligible residents by providing monthly payments through the State Supplementary Assistance program. These payments are sent in addition to the federal Supplemental Security Income benefits each month and are intended to help cover the cost of assistance related to age or disability. Funds may be used to cover some of the costs in state-licensed senior living facilities that participate in the program. Iowans who receive SSI or SSA payments are automatically eligible for Medicaid.

Applicants for SSA must be aged 65 or older or meet the Social Security definition of blind or disabled. They must also be a resident of Iowa and, if not already eligible for SSI payments, must be at or below the limit of $2,349 in monthly income and $2,000 in countable assets.

Contact: Apply for the State Supplementary Assistance program online via the DHS Services Portal or print and mail a paper application. Call (855) 889-7985 for help with the application process.

Veterans Affairs Aid and Attendance Benefit

Iowa veterans who have a low income may be eligible for the VA Aid and Attendance benefit, which provides a substantial increase to the monthly pension. The program is intended to cover the cost of personal care and assistance with everyday tasks, and this benefit can be used to help pay for senior living.

Applicants for the VA Aid and Attendance benefit must be eligible for a VA pension and meet at least one of the following criteria:

  • Requires assistance from a caregiver with some everyday tasks
  • Bedridden due to illness
  • Resident of a nursing facility due to disability
  • Very poor eyesight (with glasses or contacts)

A surviving spouse may also be eligible to claim this benefit. Due to the relatively complex requirements of the VA pension and this benefit, it’s advised to seek help from a local County Services Office. Staff can assist with the application process and potential appeals, as well as provide information on relevant programs for veterans in the county.

Contact: Applications can be submitted via mail or in person at a VA regional office. Call the Iowa Department of Veterans Affairs at (800) 838-4692 or find a nearby County Services Office for in-person help.

Senior Living Laws and Regulations in Iowa

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Senior living facilities in Iowa are regulated by the Department of Inspections and Appeals, Health Facilities Division (DIA-HFD). The rules governing senior living programs in the state can be read in full in Iowa Code chapter 231C, and a summary of important points is provided below.

Scope of Care

Senior living facilities help residents with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). This includes help with mobility, hygiene, eating and other everyday tasks. Medical care is also provided, either temporarily or intermittently, and only by appropriate health care staff. Senior living facilities cannot provide an excess of 28 hours of medical care in one week.

Occupancy Agreement

Staff must assess new residents within one month and develop an in-depth service plan, which is also known as an occupancy agreement. This agreement contains information on the resident’s cognitive and physical health, their specific needs and an individualized plan of care. Residents are monitored for changes and a review must be conducted at least once per year.

Memory Care Specific Regulations

Iowa facilities that care for people with dementia and memory loss must gain additional certification from the DIA-HFD to show accordance with state and national standards. The occupancy agreement of each resident must include a description of dementia-specific services and activities that are appropriate for their social and physical abilities. Staff must receive ongoing training that covers dementia.

Staffing Levels

Facilities must employ suitable staff to provide supervision, safety and security, and the staffing plan must factor in unscheduled needs. There is no specific ratio of caregivers to residents required. Staff must be able to respond to call lights and emergency systems at all times, and there must be at least one member on duty assigned to monitor residents. The senior living program must be managed by a registered nurse.

Staff Screening and Training

Employees of senior living facilities in Iowa must receive a satisfactory criminal background check, with proof kept on file. Nursing services may only be provided by relevant staff that are licensed by the state. Staff must be able to assist residents with activities of daily living and implement emergency procedures. Caregivers must be trained by a registered nurse employed by the facility within one month.

Prescriptions and Other Medication

By default, residents are allowed to manage their own medication, which includes storage and self-administration. Residents may be deemed unfit to self-administer by their legal representative or health care professional, or they may voluntarily delegate this responsibility to staff at any time. Senior living facilities that administer medications must employ a registered nurse to monitor for adverse reactions.

Medicaid in Senior Living

The Iowa Medicaid HCBS Elderly Waiver covers personal care received in a senior living facility, which can be arranged through the recipient’s managed care organization. The State Supplementary Assistance program may cover some senior living costs if the maximum funding on the HCBS Elderly Waiver has been met.

Iowa Senior Living Free Resources

Iowa Agencies

Iowa Department on Aging

The Iowa Department on Aging works with a network of state and local agencies and service providers to help seniors and their family members. IDA staff and contractors can provide counseling on the various benefits available, as well as health insurance and long-term care options. The department is also responsible for providing supportive services, wellness and preventative services and other programs defined under the Older Americans Act.

Contact: Call the Iowa Department on Aging at (800) 532-3213 for more information, or read about the programs and services available on the website.

Area Agencies on Aging in Iowa

Iowa is served by six Area Agencies on Aging that are partnered with the state to help seniors, caregivers and family members. Counselors are available over the phone or in person to give advice on long-term care, community support, respite and other appropriate services in the area. Case management and referrals may also be provided, as well as access to dispute resolution facilities.

View the Iowa county map of Area Agencies on Aging for local contact details, or call the Iowa Department on Aging at (800) 532-3213.

Aging Resources of Central Iowa5835 Grand Avenue Ste. 106
Des Moines, IA 50312
(515) 255-1310 or
(800) 747-5352
Connections Area Agency on Aging300 West Broadway Ste. 240
Council Bluffs, IA 51503
(712) 328-2540 or
(800) 432-9209
Elderbridge Agency on Aging22 North Georgia Ste. 216
Mason City, IA 50401-3435
(641) 424-0678 or
(800) 243-0678
Milestone Area Agency on Aging623 Pennsylvania Ave.
Ottumwa, IA 52501
(641) 682-2270 or
(855) 410-6222
Northeast Iowa Area Agency on Aging2101 Kimball Ave. Ste. 320
Waterloo, IA 50702
(319) 874-6840 or
(800) 779-8707
The Heritage Area Agency on Aging6301 Kirkwood Blvd. SW
Cedar Rapids, IA 52406
(319) 398-5559 or
(800) 332-5934

Veterans Affairs Offices in Iowa

Seniors and family members can get help applying for federal VA benefits, such as the pension and Aid and Attendance benefit, which may cover the cost of senior living. Counselors at these County Services Offices can also explain any relevant state benefits or programs for seniors in the county.

The process between application and approval can be slow when dealing with Veterans Affairs. Any denials and appeals will add to the delay, so it may be worth seeking help from a local office rather than going alone. The services provided are free of charge for veterans and their family.

Social Security Offices in Iowa

Iowa residents may be eligible for monthly benefits at the state and federal level. State Supplementary Assistance (SSA) and Supplemental Security Income (SSI) benefits can be used to help cover the cost of personal care received in senior living. Seniors who receive monthly SSI payments are automatically eligible for some other assistance programs, as detailed in this guide.

Read more about SSI and how to apply for it on the Social Security website, or find the closest location for in-person applications with the office locator.

Frequently Asked Questions

How much does assisted living cost in Iowa?

The cost of assisted living in Iowa as of 2020 is an average of $4,078 per month, which is almost identical to the national average of $4,051. Sioux City is one of the more affordable cities, with a monthly average cost of $3,700, and Iowa City is one of the most expensive at $4,500.

Does Iowa Medicaid pay for assisted living?

Yes. Medicaid may help cover the cost of personal care provided to residents in assisted living if eligible for the HCBS Elderly Waiver, but it won’t cover the room and board portion of the bill. The State Supplementary Assistance (SSA) program detailed in this guide may provide additional Medicaid funding.

What are “Activities of Daily Living”?

Activities of daily living (ADLs) are regular everyday tasks that most people take for granted. It’s a broad category that covers mobility, such as getting in and out of bed or transferring to a wheelchair, as well as showering, toileting and eating.

What is the difference between assisted living and nursing homes?

In Iowa, and in most states, assisted living facilities aren’t licensed to provide permanent medical care. Nursing or skilled nursing facilities can provide permanent medical care, and they’re staffed appropriately to do so. Residents in assisted living are generally healthier and more active than those who require nursing care.

What types of amenities are commonly in assisted living communities?

The most common amenities in Iowa’s assisted living communities include housekeeping, laundry and linen, massage and physical therapy, library and computer rooms, as well as theaters and other entertainment areas.

The Top Cities for Senior Living in Iowa

Learn more about the cost of senior living in the top Iowa cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.

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