Iowa Assisted Living
Due to its low crime rates, low cost of living, and higher-than-average life expectancy for residents, Iowa ranked as the top state for retirees in 2020. The Hawkeye State also has low median home prices and a large population of active older adults.
Iowa has several housing options for individuals needing little help with personal care and health-related tasks. This guide introduces the main types of senior care available, describes some programs that can help cover the cost of care, and includes resources for people who need health care, mental health services, or legal advice.
The typical resident population in Iowa's assisted living communities is 73% female. Overall, 89% of residents are ages 75 and older, with 30% of residents ages 75 to 84 and 59% ages 85 and older.
The Health Facilities Division of the Iowa Department of Inspections and Appeals is responsible for licensing assisted living programs (ALPs) and residential care facilities (RCFs). While both types of facilities are licensed and regulated by the same agency, they differ in terms of the populations they serve. ALPs typically serve elderly individuals, while RCFs serve a younger population, often including those with physical or intellectual disabilities. ALPs that want to provide memory care services must go through a certification process requiring the submission of a detailed staffing plan, admission and discharge policies, safety procedures, and a service plan that meets the Department's standards. With successful certification, the facility is then able to provide dementia care services to its residents.
Assisted living programs (ALPs) in Iowa provide housing and services to three or more residents who wish to maintain a home-like environment. These programs are certified to provide dementia care and can serve up to 55 residents with Stages 4 to 7 on the Global Deterioration Scale. Family involvement is strongly encouraged, and the residents are allowed to direct the decisions made regarding their living situation. This allows them to maintain their autonomy while also enjoying the security of having access to the necessary health care services they may require. ALPs in Iowa allow residents to live a safe and secure life, surrounded by their loved ones, and with the assurance of having access to the help they may need.
The resident agreement between the resident and the assisted living program (ALP) must address various topics. This agreement must include the cost of services, the terms of payment and refunds, any third-party agreements, occupancy and transfer criteria, grievance policies and procedures, emergency response policy, and staffing policy. The staffing policy outlined in the agreement should indicate whether staff is available 24 hours a day and how staff delegation policies and staffing levels are adjusted to accommodate the changing needs of the residents.
The resident agreement for dementia-specific assisted living placements (ALPs) should include not only the standard clauses but also outline the social activities provided to meet the life skill requirements of these residents. Social activities help to reduce loneliness, provide stimulation and exercise, and allow residents to practice and maintain essential life skills. In a dementia-specific ALP, activities should be tailored to the individual needs and interests of the resident. Examples include art classes, music and singing, gardening, physical exercise, and cognitive stimulation.
Individuals must meet multiple requirements for admission to and retention in an assisted living program (ALP). For instance, individuals who require assistance with four or more activities of daily living (ADLs) for more than three weeks must have assistance from two people to stand, transfer, or evacuate. Moreover, individuals who pose a threat to themselves or others, require more than part-time health-related care, or suffer from alcoholism, drug addiction, or uncontrolled mental illness are not allowed to be admitted or retained as a resident in an ALP.
Assisted living programs (ALP) must fulfill specific requirements to provide quality care for their residents. This includes providing them with personal care and health-related services. Personal care, also known as activities of daily living, requires the program to help residents with everyday tasks that they may struggle with. Health-related services must be less than skilled nursing services and professional therapies, with a maximum of 21 days allowed. ALPs must also give residents access to a 24-hour personal response system to access help when they need it.
Assessment of each resident's functional, cognitive, and health status is critical to the individualized service planning process for Assisted Living Programs (ALPs). This assessment must occur at regular intervals or when there is a significant change in their condition. The assessment team must include health and human service professionals to ensure a comprehensive evaluation and effectively plan appropriate care. Through this process, the individualized service plan will be tailored to the specific needs of each resident and will provide the foundation for providing quality care.
Sometimes, a third-party provider may provide personal care and health-related services for the assisted living program (ALP). Although the ALP is still responsible for meeting all the minimum required standards, the individual or their representative can contract directly with the third-party provider. By doing so, the resident assumes the risk and responsibility for the relationship between themselves and the provider. It is essential for the resident to be aware of the risks associated with such an arrangement and to ensure that the services provided meet their standards.
Residents of assisted living programs (ALPs) may either self-administer their medications or receive assistance from facility staff. In Iowa, nurses may delegate the responsibility of medication administration to unlicensed staff. Any ALP that administers medications must have a registered nurse (RN) monitor each resident who receives program-administered medications for any adverse reactions. The RN must also ensure that the medication orders are up to date and that they are properly administered to safeguard the health and well-being of the residents.
Assisted living programs must ensure that at least one hot meal per day is readily available to their residents. These meals should adhere to the guidelines set by the National Academy of Science for nutrition and health. If therapeutic diets are required for any residents, they must be prescribed by a health provider and approved by a licensed dietitian. The dietitian must also approve the menu, food preparation, and service procedures associated with the therapeutic diet.
State regulations outline the minimum staff requirements for assisted living programs (ALPs). A sufficient number and type of staff must be available 24 hours a day to meet the needs of the residents. Each ALP must have a program manager to oversee the facility's and its staff's daily operations. ALPs that administer medications must employ an RN to monitor medications, delegate administration, ensure that physicians’ orders remain up to date, and regularly monitor the residents' statuses. Additionally, personnel must be available to assist residents with activities of daily living (ADLs). These personnel requirements are necessary for the smooth operation of an ALP and the safety and well-being of its residents.
Before the program manager can bring a new hire on board, the new employee must undergo a criminal history check and a child and dependent adult abuse record check. The Department of Human Services will review the applicant's record to confirm that the individual is eligible to be employed. If the applicant has any criminal records, the Department of Human Services will determine whether they are still permissible to work in the role.
All personnel must have training on the program's accident, fire safety, and emergency procedures. All program managers and delegated nurses hired after January 1, 2010, must complete an assisted living management or nursing code within six months of hire.
All personnel providing services to residents with dementia must receive at least eight hours of dementia-specific education and training within 30 days of employment and an additional eight hours of continuing education annually with at least two hours specific to dementia-specific topics.
Iowa does not require all residents to have private apartments but requires that the living quarters are livable. These quarters can have either single or double occupancy and must have a bathroom, including a sink, toilet, bath, or shower. Kitchens are not required. However, they must meet all local safety and health code regulations if they exist.
There are several requirements of what each assisted living program must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
In Iowa, assisted living programs (ALPs) must provide care and services for their residents according to each resident’s care plan. This can include coordinating medical care and appointments and providing health services within the community. In Iowa, 47% of ALPs provide skilled nursing, 77% offer dental care, and 63% offer hospice services.
Mental health issues are an increasing concern, and Iowa’s assisted living programs to include services to help meet mental health needs. In Iowa, 61% of the assisted living program offer mental health counseling, and 63% have incorporated social work programs. Social workers are trained to provide counseling, conduct assessments, and assist in accessing resources necessary to support those in need.
Some assisted living residents live with various medical conditions. In Iowa, 35% have Alzheimer's disease or another form of dementia. In addition, 54% have high blood pressure, 34% have heart disease, 27% have depression, and 16% have diabetes.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores.
Residents in Iowa assisted living programs often receive help with their ADLs. In Iowa, 12% of residents need help eating. Other commonly used services include bed transfer (16%), toileting (26%), and walking (43%). Caregivers in ALFs help 41% of residents dress, and 59% need help bathing.
The average cost of assisted living care in Iowa is $4,367. This cost is $133 lower than the monthly national average of $4,500 per month. The cost of living in Iowa is less than the national average by 10.1%, with health care costs less than the national average by 0.1% and housing costs less than the national average by 24.0%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from $4,148 in the Sioux City area to $4,803 per month in the Des Moines area of Iowa.
Living close to one of Iowa’s borders may make assisted living in a neighboring state an affordable option. Three of Iowa’s neighbors have a higher average cost of assisted living. Minnesota, Wisconsin, and Illinois have average costs of $4,508, $4,600, and $4,488, respectively. Iowa's three other neighbors all have an average cost below Iowa. Nebraska, South Dakota, and Missouri have average costs of $4,076, $3,350, and $3,000, respectively.
How to Pay for Assisted Living
The Department of Inspections & Appeals (DIA) has the authority to oversee assisted living communities operating in Iowa. This agency protects people by ensuring that each assisted living community follows the rules for admitting residents and providing assisted living services. When a new resident arrives at an ALF, staff members must provide a written occupancy agreement that lists all the services it will provide, how much those services cost, and how the resident can file a grievance. The DIA also has staffing requirements to ensure that assisted living residents always have help available if they need it. For example, at least one qualified employee must always be present and awake, no matter what time of day it is, to meet the needs of residents as soon as they arise.
The term "elder law" is often associated with estate planning, trusts, and helping obtain benefits through Medicare or Medicaid. However, this field has expanded to include elder abuse, neglect, and exploitation cases. Those affected by these issues can benefit from the help of a qualified elder law attorney. These attorneys understand the complexities of elder abuse cases and are well-equipped to provide legal solutions to protect seniors from further abuse or exploitation. In addition, an elder law attorney can assist with understanding the available legal remedies and advise the best course of action for the elderly victim. With their expertise, attorneys can help ensure that older adults receive the justice and protection they deserve.
Iowa Legal Aid operates a hotline for residents ages 60 years and over with limited financial resources. Attorneys are available to help with evictions, debt settlement, and other civil matters. Iowa's Area Agencies on Aging also provide referrals to seniors needing legal advice.
The Department of Inspections & Appeals oversees assisted living communities in Iowa. This state agency inspects within 180 days of the date an ALF starts accepting residents, every two years when an ALF is due for recertification, and any time it receives a complaint regarding an Iowa ALF. The Department of Inspections & Appeals also makes its inspection reports available to the public, making it easier for individuals and their loved ones to choose a community with an excellent reputation. The Office of the State Long-Term Care Ombudsman also resolves complaints about assisted living communities and advocates for quality care in assisted living and other residential settings.
The Department of Inspections & Appeals must certify all assisted living communities. To qualify for certification, an ALF must meet stringent requirements regarding admissions, care plans, dietary services, and staffing. For example, an ALF isn't permitted to accept a resident with an uncontrolled mental illness or who needs more than part-time health care for longer than 21 days. Meals provided to assisted living residents must meet the National Academy of Science Food and Nutrition Board’s nutritional standards. Although Iowa doesn't have a minimum staff-to-resident ratio, every ALF must have a program manager responsible for staffing and daily operations.
Iowa has several housing options for individuals needing little help with personal care and health-related tasks. This guide introduces the main types of senior care available, describes some programs that can help cover the cost of care, and includes resources for people who need health care, mental health services, or legal advice.
The typical resident population in Iowa's assisted living communities is 73% female. Overall, 89% of residents are ages 75 and older, with 30% of residents ages 75 to 84 and 59% ages 85 and older.
Assisted Living Facility (ALF) Requirements
The Health Facilities Division of the Iowa Department of Inspections and Appeals is responsible for licensing assisted living programs (ALPs) and residential care facilities (RCFs). While both types of facilities are licensed and regulated by the same agency, they differ in terms of the populations they serve. ALPs typically serve elderly individuals, while RCFs serve a younger population, often including those with physical or intellectual disabilities. ALPs that want to provide memory care services must go through a certification process requiring the submission of a detailed staffing plan, admission and discharge policies, safety procedures, and a service plan that meets the Department's standards. With successful certification, the facility is then able to provide dementia care services to its residents.
Assisted living programs (ALPs) in Iowa provide housing and services to three or more residents who wish to maintain a home-like environment. These programs are certified to provide dementia care and can serve up to 55 residents with Stages 4 to 7 on the Global Deterioration Scale. Family involvement is strongly encouraged, and the residents are allowed to direct the decisions made regarding their living situation. This allows them to maintain their autonomy while also enjoying the security of having access to the necessary health care services they may require. ALPs in Iowa allow residents to live a safe and secure life, surrounded by their loved ones, and with the assurance of having access to the help they may need.
Resident Agreements and Admission Policies
The resident agreement between the resident and the assisted living program (ALP) must address various topics. This agreement must include the cost of services, the terms of payment and refunds, any third-party agreements, occupancy and transfer criteria, grievance policies and procedures, emergency response policy, and staffing policy. The staffing policy outlined in the agreement should indicate whether staff is available 24 hours a day and how staff delegation policies and staffing levels are adjusted to accommodate the changing needs of the residents.
The resident agreement for dementia-specific assisted living placements (ALPs) should include not only the standard clauses but also outline the social activities provided to meet the life skill requirements of these residents. Social activities help to reduce loneliness, provide stimulation and exercise, and allow residents to practice and maintain essential life skills. In a dementia-specific ALP, activities should be tailored to the individual needs and interests of the resident. Examples include art classes, music and singing, gardening, physical exercise, and cognitive stimulation.
Individuals must meet multiple requirements for admission to and retention in an assisted living program (ALP). For instance, individuals who require assistance with four or more activities of daily living (ADLs) for more than three weeks must have assistance from two people to stand, transfer, or evacuate. Moreover, individuals who pose a threat to themselves or others, require more than part-time health-related care, or suffer from alcoholism, drug addiction, or uncontrolled mental illness are not allowed to be admitted or retained as a resident in an ALP.
Assisted Living Services
Assisted living programs (ALP) must fulfill specific requirements to provide quality care for their residents. This includes providing them with personal care and health-related services. Personal care, also known as activities of daily living, requires the program to help residents with everyday tasks that they may struggle with. Health-related services must be less than skilled nursing services and professional therapies, with a maximum of 21 days allowed. ALPs must also give residents access to a 24-hour personal response system to access help when they need it.
Assessment of each resident's functional, cognitive, and health status is critical to the individualized service planning process for Assisted Living Programs (ALPs). This assessment must occur at regular intervals or when there is a significant change in their condition. The assessment team must include health and human service professionals to ensure a comprehensive evaluation and effectively plan appropriate care. Through this process, the individualized service plan will be tailored to the specific needs of each resident and will provide the foundation for providing quality care.
Sometimes, a third-party provider may provide personal care and health-related services for the assisted living program (ALP). Although the ALP is still responsible for meeting all the minimum required standards, the individual or their representative can contract directly with the third-party provider. By doing so, the resident assumes the risk and responsibility for the relationship between themselves and the provider. It is essential for the resident to be aware of the risks associated with such an arrangement and to ensure that the services provided meet their standards.
Assisted Living Medication Provisions
Residents of assisted living programs (ALPs) may either self-administer their medications or receive assistance from facility staff. In Iowa, nurses may delegate the responsibility of medication administration to unlicensed staff. Any ALP that administers medications must have a registered nurse (RN) monitor each resident who receives program-administered medications for any adverse reactions. The RN must also ensure that the medication orders are up to date and that they are properly administered to safeguard the health and well-being of the residents.
Assisted Living Food Requirements
Assisted living programs must ensure that at least one hot meal per day is readily available to their residents. These meals should adhere to the guidelines set by the National Academy of Science for nutrition and health. If therapeutic diets are required for any residents, they must be prescribed by a health provider and approved by a licensed dietitian. The dietitian must also approve the menu, food preparation, and service procedures associated with the therapeutic diet.
Assisted Living Staffing Requirements
State regulations outline the minimum staff requirements for assisted living programs (ALPs). A sufficient number and type of staff must be available 24 hours a day to meet the needs of the residents. Each ALP must have a program manager to oversee the facility's and its staff's daily operations. ALPs that administer medications must employ an RN to monitor medications, delegate administration, ensure that physicians’ orders remain up to date, and regularly monitor the residents' statuses. Additionally, personnel must be available to assist residents with activities of daily living (ADLs). These personnel requirements are necessary for the smooth operation of an ALP and the safety and well-being of its residents.
Before the program manager can bring a new hire on board, the new employee must undergo a criminal history check and a child and dependent adult abuse record check. The Department of Human Services will review the applicant's record to confirm that the individual is eligible to be employed. If the applicant has any criminal records, the Department of Human Services will determine whether they are still permissible to work in the role.
Assisted Living Staff Training Requirements
All personnel must have training on the program's accident, fire safety, and emergency procedures. All program managers and delegated nurses hired after January 1, 2010, must complete an assisted living management or nursing code within six months of hire.
All personnel providing services to residents with dementia must receive at least eight hours of dementia-specific education and training within 30 days of employment and an additional eight hours of continuing education annually with at least two hours specific to dementia-specific topics.
Assisted Living Housing Requirements
Iowa does not require all residents to have private apartments but requires that the living quarters are livable. These quarters can have either single or double occupancy and must have a bathroom, including a sink, toilet, bath, or shower. Kitchens are not required. However, they must meet all local safety and health code regulations if they exist.
What Is Included With Assisted Living Care In Iowa?
There are several requirements of what each assisted living program must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Health Care Services
In Iowa, assisted living programs (ALPs) must provide care and services for their residents according to each resident’s care plan. This can include coordinating medical care and appointments and providing health services within the community. In Iowa, 47% of ALPs provide skilled nursing, 77% offer dental care, and 63% offer hospice services.
Mental health issues are an increasing concern, and Iowa’s assisted living programs to include services to help meet mental health needs. In Iowa, 61% of the assisted living program offer mental health counseling, and 63% have incorporated social work programs. Social workers are trained to provide counseling, conduct assessments, and assist in accessing resources necessary to support those in need.
Some assisted living residents live with various medical conditions. In Iowa, 35% have Alzheimer's disease or another form of dementia. In addition, 54% have high blood pressure, 34% have heart disease, 27% have depression, and 16% have diabetes.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores.
Residents in Iowa assisted living programs often receive help with their ADLs. In Iowa, 12% of residents need help eating. Other commonly used services include bed transfer (16%), toileting (26%), and walking (43%). Caregivers in ALFs help 41% of residents dress, and 59% need help bathing.
Cost Of Assisted Living Care In Iowa
The average cost of assisted living care in Iowa is $4,367. This cost is $133 lower than the monthly national average of $4,500 per month. The cost of living in Iowa is less than the national average by 10.1%, with health care costs less than the national average by 0.1% and housing costs less than the national average by 24.0%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from $4,148 in the Sioux City area to $4,803 per month in the Des Moines area of Iowa.
How Costs Compare In Nearby States
Living close to one of Iowa’s borders may make assisted living in a neighboring state an affordable option. Three of Iowa’s neighbors have a higher average cost of assisted living. Minnesota, Wisconsin, and Illinois have average costs of $4,508, $4,600, and $4,488, respectively. Iowa's three other neighbors all have an average cost below Iowa. Nebraska, South Dakota, and Missouri have average costs of $4,076, $3,350, and $3,000, respectively.
How to Pay for Assisted Living
Iowa Assisted Living Oversight
The Department of Inspections & Appeals (DIA) has the authority to oversee assisted living communities operating in Iowa. This agency protects people by ensuring that each assisted living community follows the rules for admitting residents and providing assisted living services. When a new resident arrives at an ALF, staff members must provide a written occupancy agreement that lists all the services it will provide, how much those services cost, and how the resident can file a grievance. The DIA also has staffing requirements to ensure that assisted living residents always have help available if they need it. For example, at least one qualified employee must always be present and awake, no matter what time of day it is, to meet the needs of residents as soon as they arise.
Legal Resources for Seniors
The term "elder law" is often associated with estate planning, trusts, and helping obtain benefits through Medicare or Medicaid. However, this field has expanded to include elder abuse, neglect, and exploitation cases. Those affected by these issues can benefit from the help of a qualified elder law attorney. These attorneys understand the complexities of elder abuse cases and are well-equipped to provide legal solutions to protect seniors from further abuse or exploitation. In addition, an elder law attorney can assist with understanding the available legal remedies and advise the best course of action for the elderly victim. With their expertise, attorneys can help ensure that older adults receive the justice and protection they deserve.
Iowa Legal Aid operates a hotline for residents ages 60 years and over with limited financial resources. Attorneys are available to help with evictions, debt settlement, and other civil matters. Iowa's Area Agencies on Aging also provide referrals to seniors needing legal advice.
Quality and Safety of Assisted Living Programs in Iowa
The Department of Inspections & Appeals oversees assisted living communities in Iowa. This state agency inspects within 180 days of the date an ALF starts accepting residents, every two years when an ALF is due for recertification, and any time it receives a complaint regarding an Iowa ALF. The Department of Inspections & Appeals also makes its inspection reports available to the public, making it easier for individuals and their loved ones to choose a community with an excellent reputation. The Office of the State Long-Term Care Ombudsman also resolves complaints about assisted living communities and advocates for quality care in assisted living and other residential settings.
The Department of Inspections & Appeals must certify all assisted living communities. To qualify for certification, an ALF must meet stringent requirements regarding admissions, care plans, dietary services, and staffing. For example, an ALF isn't permitted to accept a resident with an uncontrolled mental illness or who needs more than part-time health care for longer than 21 days. Meals provided to assisted living residents must meet the National Academy of Science Food and Nutrition Board’s nutritional standards. Although Iowa doesn't have a minimum staff-to-resident ratio, every ALF must have a program manager responsible for staffing and daily operations.
