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Nursing homes in Iowa

Iowa has 387 Medicare- or Medicaid-certified nursing homes in 99 counties, with 25,131 certified beds in total. The state average CMS overall rating is 3.1 of 5 against a national average of 3.0, and homes report 3.82 nurse staffing hours per resident per day against 3.86 nationally.

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Iowa against the national average

MeasureIowaUnited States
Overall rating (1 to 5)3.13.0
Health inspection rating2.82.8
Staffing rating3.72.9
Nurse staffing hours per resident per day3.823.86
Registered nurse hours per resident per day0.740.69
Nursing staff turnover44.0%45.8%
Health deficiencies in the latest inspection6.59.2
Fines per home, past three years0.60.9

Averages are published by CMS. Health inspection ratings are set within each state, so compare them across states with care.

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Cities with at least 3 homes, by the city in each home's CMS address. Every home is also listed by county below.

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Nursing home rules and contacts in Iowa

Federal rules on residents' rights, discharge notices and Medicare coverage are the same in every state. These are the offices to call in Iowa, and the rules the state sets for itself.

Minimum staffing
Iowa's nursing facility licensing rules do not set an hours-per-resident-day minimum. They require: in homes with 75 or more beds, a qualified nurse (RN or LPN) on duty 24 hours a day, seven days a week, and a registered nurse as health service supervisor; in homes under 75 beds with an LPN supervisor, an RN consultant on site at least four hours a week; and at least two people capable of nursing service awake and on duty at all times. The state may set staffing for an individual home and may grant waivers. Source: 481 Iowa Admin. Code 58.11(2), 58.1, 58.2; Iowa Code 135C.14(6)
Personal needs allowance (Medicaid)
Iowa law sets the Medicaid personal needs allowance for a nursing facility resident at $55 per month. A 2025 law (House File 1049) raised it from $50. A resident whose income is below $55 a month receives a state-funded supplement to reach $55, if the legislature has appropriated money for it. Residents with earned income may keep an additional $65 per month from that income. Source: Iowa Code 249A.30A (as amended by 2025 Iowa Acts ch. 169 [HF 1049] sec. 19); 441 Iowa Admin. Code 75.83(2)(a), 81.18; Iowa Code 3.7(1)
Holding a bed during a hospital stay or leave
Iowa Medicaid rules allow bed-hold days of up to 18 days per calendar year for overnight visits or vacation (more if the physician's plan of care says extra days would be rehabilitative) and up to 10 days per calendar month for hospital stays, but pay for these absences at zero percent of the home's rate, except special population and state-operated homes, which receive 42 percent. When a resident who has not been discharged is away overnight, the resident, family or friends may pay to hold the bed. Under state licensing rules, a home must ask whether the resident wants the bed held and must hold it as long as payments are made under the contract. Source: 441 Iowa Admin. Code 81.8(3)(d)-(f), 81.8(4)(e)(1); 481 Iowa Admin. Code 58.13(7)
Visiting
Iowa's licensing rules say residents must be permitted to receive visitors in line with the federal rule (42 CFR 483.10(f)(4)). A home may restrict a particular visitor if the visitor's behavior is unreasonably disruptive to the functioning of the home; the administrator must make that judgment and document the reasons. Restrictions must be reviewed each time the physician reviews medical orders, at least quarterly, or at the resident's request. Married residents must be ensured privacy for spouse visits, and spouses living in the same home may share a room if one is available. Source: 481 Iowa Admin. Code 58.47(1)-(3), 58.50
Discharge notice
Iowa requires written notice at least 30 days before an involuntary transfer or discharge, with exceptions (for example emergencies, where written notice must be given before or within 48 hours after the transfer or discharge). Copies go to the state licensing agency, the responsible party, the primary care provider, the placing agency and the long-term care ombudsman office. The resident may request a hearing from DIAL, in writing or verbally, within 7 days of receiving the notice; the hearing is held before an administrative law judge no later than 14 days after DIAL receives the request, unless either party asks for an extension due to emergency circumstances. Except in emergencies, the request stops the move until a final decision, including appeals. Source: 481 Iowa Admin. Code 58.40(5)-(7); Iowa Code 135C.14(8)(b)
When private funds run out
Iowa law says a resident of a licensed health care facility, including a nursing facility, shall not be discharged solely because their care is paid by Medicaid or because their payment source is changing from private funds to Medicaid. State rules repeat this for nursing facilities, and a violation is at least a class II violation and may be a class I violation. Source: Iowa Code 135C.31, 135C.36(2); 481 Iowa Admin. Code 58.40(4)

Checked against Iowa state sources on Oct 11, 2026. Rules and phone numbers change, so confirm with the office listed. For the rules that apply in every state, see residents' rights, how to file a complaint and how Medicaid pays for a nursing home.

Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026.