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Nursing Homes in Iowa

Nursing home care is for seniors who require comprehensive medical services and constant supervision. Assisted living communities and home health care services aid with activities of daily living, but the level of care isn’t as intensive as that of a nursing home. Nursing facilities provide extensive senior health care in a residential setting and typically offer life-enriching activities and entertainment for residents.

Iowa has a senior population comprising 17.7% of the state’s 3,200,517 residents. The percentage is higher than the nation’s 16.8% average for residents 65 and older. About 20,077 Iowans live in nursing homes where they receive around-the-clock supervision and services such as IV insertion and maintenance, physical and other therapies, wound care, rehabilitative services and regular wellness checks. To serve them and seniors transitioning from home to a nursing facility, there are 433 nursing homes in the state. This guide contains information about paying for nursing home care with Medicaid and Medicare, along with a list of resources and state nursing facility regulations. 

Popular Cities in Iowa

Des Moines

Cost of Iowa Nursing Homes

The average cost of nursing homes in Iowa is $175 per day. This is higher than the national average which is $228 per day.

 

Can You Use Medicaid to Pay for Nursing Home Care in Iowa?

Eligible Iowa seniors in need of nursing home care can use Medicaid to pay for costs. Since October 2013, the number of Iowans enrolled in Medicaid and CHIP has increased by 71.25%, for a total of 845,136. Nursing facilities are a long-term care option for residents who need a higher level of care than can be provided at home or at an assisted living community.

Advantages of nursing homes include medical staff on-site 24/7, around-the-clock supervision and planned recreational activities in a homelike setting. Seniors age 65 and over who are medically deemed in need of nursing facility care may qualify for the Medicaid HCBS Elderly Waiver Program, which can provide services including but not limited to case management and nutritional counseling.

Eligibility for Medicaid in Iowa

There are income and asset limits seniors must meet to qualify for Iowa Medicaid. Single applicants can’t exceed $32,904 in annual income, and the asset limit is $2,000. For a two-person household, the yearly income limit is $65,808, while the asset limit is $3,000.

Income Limits*Asset Limits
Single Person$32,904$2,000
Two-Person Household$65,808$3,000

*Per year

Applicants must meet other requirements to qualify for Medicaid in Iowa. Here are some of the eligibility requirements for nursing home Medicaid coverage:

  • Age 65 and over
  • Medically determined to need nursing-level care
  • U.S. citizen or legal resident
  • Resident of Iowa

Applying for Medicaid in Iowa

One way to apply for Medicaid in Iowa is online through the Department of Human Services (DHS) portal. Applications can also be mailed to:

DHS – Centralized Facility Eligibility Unit at Imaging Center 1
Iowa Department of Human Services
417 East Kanesville Boulevard, Council Bluffs, IA 51503 

Medicaid applications can be downloaded and printed. People applying for nursing home care should write NURSING FACILITY MEDICAID on Page 1 of the application. Seniors or their representatives can also complete, scan and email a paper application to facilities@dhs.state.ia.us. Alternatively, applications can be faxed to (515) 564-4040. Documentation of information may be required.

What Information You Will Need

  • Completed Medicaid application
  • Proof of identity and citizenship status
  • Copy of Medicare and any other insurance benefit policies
  • Proof of income and assets
  • Level of care assessment by a physician
  • Release of Information form

Additional Medicaid Support & Resources in Iowa

People who need assistance with Medicaid applications have multiple options. The following chart lists three ways that Iowa residents can get help with long-term care benefits, such as nursing home coverage. 

ContactService
Iowa Medicaid Member Services(855) 889-7985Medicaid member services representatives help Iowa seniors or their legal representatives with applications and questions.
Iowa Department on Aging(866) 468-7887Through this office of the Iowa Department on Aging, seniors and their family members can receive counseling and assistance on Medicaid-related topics.
BenefitsCheckUp(800) 794-6559The BenefitsCheckUp service connects Iowa seniors with the right benefits programs for them. This service also has benefit enrollment specialists to help with the application process from start to finish.

Can You Use Medicare to Pay for 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 & Resources in Iowa

Medicare may be able to help with various senior costs in Iowa even though it does not cover long-term nursing home stays. Seniors or their families needing help with Medicare applications have options such as the following.

ContactService
Medicare.govMedicare.gov offers a Live Chat feature
(800) 633-4227.
The Medicare.gov website has informative articles about Medicare plans and coverage for seniors. Applicants with questions can get help online or over the phone.
Iowa Association of Area Agencies on AgingReach this organization via its Contact webpage.Local AAA offices can help seniors and their family members with understanding and applying for Medicare benefits.
Iowa Department on Aging(866) 468-7887The Iowa Department on Aging is a hub for seniors in nursing care and their family members and caregivers. The office provides counseling and referrals regarding Medicare coverage and other senior-centric topics.

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.

How to ApplyHow It Works
Aid and AttendanceLearn 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 MortgagesLearn 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. 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 (LTC) InsuranceLearn 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 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.

Nursing Home Laws and Regulations in Iowa

Licensing RequirementsIowa nursing facilities are licensed by the Iowa Department of Inspections and Appeals, and licenses last for one year. Nursing homes are required by Iowa state law to apply for renewal at least 30 days before expiration of the current license.
Staffing RequirementsIn Iowa, nursing home staff must provide two hours of individual care daily per resident. Licensed nurses must provide 20% of said care. For facilities with 75 or more beds, a nurse is required to be on-site 24 hours a day, 7 days a week.
Staff Training RequirementsIowa nurses' aides and assistants must complete a 20-hour on-the-job training program or a 75-hour nurses' aide program. These programs must be state-approved. Nursing homes must also provide staff with ongoing training regarding resident care.
Admission RestrictionsResidents must require nursing-home level care that assisted living or home care can't provide. Also, the number of residents cannot exceed the number of licensed beds.
Care Planning RequirementsIndividualized care plans are required for every Iowa nursing home resident. These plans are developed in conjunction with the resident's physician. All care plans must be in writing and offered to every caregiver of the resident. Care plans can be revised as needs change.
Dietary and Nutritional Services RequirementsRegistered dieticians supervise all meals, and menus must be published one week ahead of time. Iowa guidelines state nursing home meals must meet 100% of recommended dietary allowances and accommodate special dietary needs.
Specialized Rehabilitative ServicesIowa nursing homes must have the ability to provide specialized rehabilitative services. An agreement with a physical therapist is required. Therapy can take place at the nursing facility or off-site and must include occupational and audiology therapies in addition to physical therapy.
Medication and Pharmaceutical ServicesPhysicians must order medication administration at nursing homes, and injectable medicines are only administered by a licensed nurse. Iowa nursing homes are required to store drugs in a locked cabinet and clearly label all medicines.
Activities RequirementsIowa nursing homes must provide day and evening recreation for residents in individual and group settings. These activities should be designed around residents' interests and abilities.
Infection Control RequirementsEvery Iowa nursing home must have a written infection control plan. The protocol must be modeled after U.S. Department of Health and CDC guidelines. Each facility should have an infection control committee.
Medicaid CoverageMany seniors can receive Iowa Medicaid coverage for nursing home costs. There are income, asset and other eligibility requirements.

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