Iowa Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: November 13, 2022


In Iowa, memory care is called Dementia-Specific Assisted Living Programs. These facilities provide meals, room and board. Additionally, they support personal and health-related care including assistance with activities of daily living.

Assisted living communities must be approved by the Iowa Health Facilities Division’s Department of Inspections and Appeals before they can admit people with dementia. They focus their inspection on staffing, service plans, design, and safety. The service plans, which explain how people with dementia are cared for, must include planned and spontaneous activities based on a resident’s abilities and interests.

There are about 150 memory care homes throughout Iowa. There are also approximately 34 board and care homes, which offer the same services as assisted living, in a smaller home-like setting. For free help finding memory care to meet your family’s needs and budget, click here.

 Did You Know? It is estimated that over the next five years there is only going to be a 10% increase in the number of people over 65 in Iowa, one of the lowest rates in the country. Iowa also has one of the lowest average retirement incomes of approximately $21,000 per year. This makes financial assistance for memory care important.


How Much Does Memory Care Cost in Iowa?

The average cost of memory care in 2022 in Iowa is $5,300 per month. The state’s most expensive place for memory care is Des Moines where memory care costs $5,816 per month. Memory care is least expensive to the northwest, in Sioux City where it costs on average $5,006 per month.

 In Iowa, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

Iowa’s memory care costs are a bit below the national average of $5,448, but that does not mean that you can not find more options or potential savings in a nearby state. Iowans interested in looking across the state border might find options in Minnesota, where the average monthly cost of memory care is $5,448. In South Dakota the monthly cost of memory care is $4,049 and in Nebraska $4,932 monthly. Southern Iowans should consider Missouri, which is the least expensive state for memory care costing $3,644 per month.

Other cities and their average memory care costs:

Iowa Memory Care / Assisted Living Costs (updated Sept. 2022)
Region / City Daily Cost Monthly Cost
Statewide $174 $5,300
Des Moines $191 $5,816
Cedar Rapids $189 $5,742
Davenport $173 $5,264
Sioux City $165 $5,006
Iowa City $175 $5,337
Ames $185 $5,632


Iowa Assisted Living Laws & Regulations

 Covid 19-Related Measures (updated Sept. 2022)
Residents – Their temperatures are checked and patients are also tested regularly.
Visitors – Can visit loved ones, must wear a mask and temperature is checked upon entry.
Staff – Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

Within 30 days of moving in, all residents must be assessed for functional, cognitive, and health status. This must be updated every year. The assessment is used to create a personalized care plan that reflects medical and personal needs. It details medications, assistance with activities of daily living, and activities that are appropriate for one’s mental and physical abilities. The cost of the assessment might be an extra community charge that also covers up-front costs like deep cleaning and painting. Community fees generally range between $1,500 to $2,500.

All assisted living homes in Iowa must provide documentation to potential residents that includes the following information:

– Description of all costs including potential additional charges
– Procedure for nonpayment
– The term of occupancy
– A promise to notify the resident 30 days in advance of any changes
– Transfer or eviction criteria and process
– Procedure for filing a grievance
– Emergency response policy
– Staffing details including the number of nurses per-shift
– Details of all programs that encourage activity and socialization for people with dementia
– Refund policy

Someone with the following issues may not be admitted into Iowa assisted living:

– Requires full-time nursing care
– Is bed-bound
– Is under 18 years old
– Requires two people to help with standing or going to the bathroom
– Has unmanageable chronic incontinence
– Is dangerous to themselves and others
– Has alcohol or drug addiction

Assisted living homes can not admit someone whose care needs cannot be fulfilled there. A doctor’s diagnosis of dementia is not required to move into memory care in Iowa.

It is possible to move into assisted living in Iowa on short notice, but this is not a good idea. Finding the right memory care community for your loved one is important. You should investigate as many potential homes as possible before making a decision taking tours and asking residents and staff questions. Additionally, your loved one will have more input into the decision the earlier you start looking.


Facility / Residence

A single-occupancy room must be at least 190 square feet. Double-occupancy rooms must be a minimum of 290 square feet. These sizes exclude bathrooms. Every living unit needs a toilet, sink, and bath or shower. Two people is the maximum allowed in a living unit. In memory care, all exit doors must be equipped with alarms, to notify staff in case of a resident wandering outside.

Iowa regulations do not say that dementia-friendly designs are required for memory care units. This means features like circular hallways that don’t encounter dead ends, and secure outdoor areas for walking and fresh air. Inspect any home you are considering, looking with the comfort of your loved one in mind.


Staff & Training

There are no staff-to-resident ratios in Iowa.  However, there must be sufficient staffing at all times to meet the needs of every resident. Someone must be on duty 24 hours per day. All assisted living communities must be overseen by a registered nurse. Administrators must have six hours of training about Iowa assisted living laws. For all other staff, training must include how to assist with activities of daily living and instrumental activities of daily living. Anyone working with residents with dementia must have at least eight hours of dementia-specific training within 30 days of hiring, and then updated on an annual basis.


Evictions & Discharges

Regulations say someone can be evicted for becoming dangerous (to themselves or others) or if their medical condition cannot be handled by staff at the residence. There is not a state-mandated process for memory care evictions in Iowa. This means each residence makes its own rules about evictions and the discharge process. Those rules must be provided in writing to anyone considering moving in. Be sure to ask for this documentation, and be very clear about exactly what it takes to be evicted before agreeing to move in. For more information on memory care evictions, including what to do if your loved one receives one, click here.


Financial Assistance for Residential Alzheimer’s Memory Care

HCBS Elderly Waiver

Iowa’s Home and Community Based Services waiver is a Medicaid waiver that helps cover costs including care within assisted living. It is designed to help people who need medical care remain in their own homes or assisted living communities. This means that they would not have to transfer to an expensive nursing home. The waiver includes a Consumer Choices Option and Consumer Directed Attendant Care Option. The waiver provides flexibility to shop for services that help with issues like transportation and assistance with activities of daily living. Medicaid cannot cover costs of room and board, but other needs including medical devices may be covered. Read more about Iowa Medicaid eligibility guidelines for 2022 or take an eligibility test. For more information, click here. To apply, contact your local Department of Human Services office.


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.


VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2022 to December 2023. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,073

– Veterans with dependent spouses or children up to $21,001

– Surviving spouses without dependent children up to $10,756

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $26,751

– Veterans with dependent spouses or children a maximum of $31,713

– Surviving spouses without dependent children a maximum of $17,191

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $19,598

– Veterans with dependent spouses or children a maximum of $24,562

– Surviving spouses without dependent children a maximum of $13,145

 More information on VA Pensions’ eligibility criteria, payment rates and the application process is available here.

Veterans Homes

There is one veterans’ home in Iowa. It is in Marshalltown, about an hour northeast of Des Moines. The Iowa Veterans Home is a residential care facility that provides long-term care for veterans. In addition to nursing home care, assisted living and memory care are also provided to more than 500 veterans on the 150-acre campus. Neighboring states also have veterans’ homes, so your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Missouri has seven veterans’ homes statewide. Additionally, Minnesota has five facilities. More info.


Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.