Iowa Veterans Home

The Iowa Veterans Home is a long-term health care facility in Marshalltown providing both nursing and residential, or domiciliary, levels of care. It is run by the department of veterans affairs under the commission's oversight. The statute is chapter 35D and the operating detail is 801 Iowa Administrative Code chapter 10. Who may be admitted. Section 35D.1, subsection 1 names four classes: "honorably discharged veterans and their dependent spouses, surviving spouses of honorably discharged veterans, and gold star parents." Gold star parent is defined in the same subsection as "a parent of a deceased member of the United States armed forces who died while serving on active duty during a time of military conflict or who died as a result of such service." Few state homes in this catalog admit a bereaved parent at all. The section then imports federal eligibility: "Eligibility requirements for admission to the Iowa veterans home shall coincide with the eligibility requirements for care and treatment in a United States department of veterans affairs facility pursuant to 38 U.S.C. §1710, and regulations promulgated under that section." The department's rule at 801-10.2(1)(e) restates it as being eligible for care at a VA medical center "(excluding financial eligibility)", so the federal means test does not import. Four further conditions, and one of them surprises people. Section 35D.2, subsection 1 admits persons described in section 35D.1 "who are disabled by disease, injury, or old age, and who meet the qualifications for nursing or residential care, and who are unable to earn a livelihood, and who are residents of the state of Iowa on the date of the application and immediately preceding the date the application is accepted." "Unable to earn a livelihood" is a real condition, and the rule makes it stricter in one direction. Rule 801-10.2(1)(b): "The individual cannot be competitively employed on the day of admission or throughout the individual's residency." The words "or throughout the individual's residency" mean this is not only an admission test. A resident who becomes competitively employable has, on the face of the rule, stopped meeting a condition of residency. Raise it with the home before taking work. Homelessness helps rather than hurts. Section 35D.2, subsection 1: "The commission shall adopt rules to emphasize the admission of homeless honorably discharged veterans." Rule 801-10.2(1)(g): "Homelessness does not disqualify persons otherwise eligible for admission to IVH." Who is excluded. Section 35D.2, subsection 2: a person shall not be received or retained who "has been diagnosed by a qualified mental health professional as acutely mentally ill and considered dangerous to self or others, is an acute inebriate, or is addicted to the use of drugs, and whose documented behavior is continuously disruptive to the operation of the facility." An allied nation's veteran can be admitted. Rule 801-10.2(4): an individual who was not a member of the United States armed forces may be eligible if "The individual was a member of the armed services of a nation with which the United States was allied during a time of conflict" and "is eligible for admission to a DVA medical center in accordance with U.S.C. Title 38, Chapter 17". This is a genuinely unusual door and it is in the rules, not the statute. The quarter cap on family members, which is the constraint nobody plans for. Rules 801-10.2(2)(d) and 10.2(3)(f): "Spouses, surviving spouses and Gold Star parents admitted to IVH shall not exceed more than 25 percent of the total number of members at IVH as provided in U.S.C. Title 38." So a spouse's admission depends on the current census, not only on their own eligibility. Ask where the home stands against that 25 percent before planning a couple's move. Spouses and surviving spouses, the terms. Section 35D.4: a spouse may be admitted if married to the member for at least one year and otherwise eligible, and "Veteran and spouse members may be permitted to occupy, together, cottages or other quarters on the grounds of the home." Rule 801-10.2(2)(b) adds the hard limit: "The spouse of a veteran is eligible for admittance to IVH only if the veteran is admitted." Section 35D.5 covers a surviving spouse: married at least one year immediately prior to death, found by the department to be disabled, meeting the nursing or residential care qualifications, and an Iowa resident on the application date and immediately preceding acceptance. What it costs, and the case where it costs nothing. There is no published rate to quote, and that is the honest answer. Rule 801-10.15(1) sets the nursing and domiciliary per diems by calculating cost in January and July of each year for the preceding six months, with the updated rate effective on March 1 and September 1 and a month's advance notice to the member. Rule 801-10.14(1) then bills the member for billable days times the per diem, reduced by offsets, and "The member or legal representative shall pay an amount not to exceed the amount calculated based on the resources available for the cost of care". It is an ability-to-pay charge against a moving rate. Then rule 801-10.15(2), which is the most valuable sentence in the chapter. Where the home receives the enhanced federal per diem under 38 U.S.C. section 1745(a), established by section 211 of the Veterans Benefits, Health Care, and Information Technology Act of 2006, for a veteran with service-connected disabilities receiving nursing home care in a state home: "If IVH receives this higher per diem rate from the DVA, the member will not have a support charge from IVH." No charge at all. The federal enhanced per diem generally turns on a service-connected disability rated 70 percent or more, or nursing home care required for a service-connected disability, so a veteran in that position should establish it before assuming they owe anything. Other reductions. The daily charge is reduced by the member's Medicare Part B and Part D premiums under rule 10.15(3) and by other medical insurance premiums under rule 10.15(4). A member on VA pension with aid and attendance "shall be considered as having used the amount equal to aid and attendance first in payment for their care", under rule 10.15(5). Title XIX residents have their payment set by the department of human services income maintenance worker. The statute's own threshold is a frozen figure. Section 35D.7, subsection 1 requires a contribution from a member who receives a federal pension, compensation or gratuity "or income from any source of more than one hundred forty dollars per month". The $140 has not moved and today catches essentially everyone; the operative machinery is the rules, not this number. The same subsection caps the contribution at "the actual cost of keeping and maintaining the person in the home". Half your check goes to your spouse, by statute. Section 35D.10: a member who receives a pension or compensation and has a spouse "shall deposit with the department on receipt of the member's pension or compensation check one-half of its amount, which shall be sent by the eighth day of the month" to the spouse. This is mandatory, not elective. Leave days and hospital days are counted and they cost money past a point. Rule 801-10.14(3): all in-house days are billable; leave days above the first 12 free days and up to the fifty-ninth are billable at the resources-based amount; and "Any leave days in excess of 59 days shall be considered billable, and the member must pay the full support rate, not the amount determined by resources." So a long absence flips the charge from ability-to-pay to full price. The first ten days of each hospitalization are billable, and after ten days "IVH assumes the authority to discharge the resident but reserves the right to negotiate an extension to the bed hold". Payment timing. Rule 801-10.15(6): support is due within ten business days after the bill is received or after the member's last income deposit for the month, and "If payment is not received by IVH within 30 days following the due date, a notice of discharge may be issued." Extenuating circumstances can be worked out with the commandant. Being discharged, and the protections around it. Section 35D.15, subsection 2 lists four grounds for involuntary discharge: continued substance abuse in violation of a conditional or provisional admission agreement, after notice of three offences and an opportunity to correct; refusal to use the resources identified in the member's collaborative care plan, on the same notice pattern; no longer requiring a residential or nursing level of care; and requiring a level of licensed care the home does not provide. Demonstrated progress toward the care plan's goals lets the interdisciplinary resident care committee and the department exercise discretion not to discharge. Immediate discharge is available where the member's actions jeopardise the life or safety of members or staff. The procedure is tightly timed and worth knowing in advance. Written notice, with discharge effective thirty calendar days from receipt unless immediate. Appeal to the commission within five calendar days of receiving the notice. Commission decision in writing within ten calendar days of the filing. Further appeal to the department of inspections, appeals and licensing within five calendar days of that decision, and a decision within fifteen calendar days. The whole thing is capped: "The maximum time period that shall elapse between receipt by the member of the discharge notice and actual discharge shall not exceed fifty-five days." And judicial review under chapter 17A stays the discharge while it is pending. Two substantive duties attach to a discharge, and they are unusually strong. The discharge plan must include "placement in a suitable living situation", and the department shall, "to the greatest extent possible, ensure against the veteran being homeless and ensure that the domicile to which the veteran is discharged is fit and habitable and offers a safe and clean environment which is free from health hazards and provides appropriate heating, ventilation, and protection from the elements." The department must report annually, by the fourth Monday of each session, to the senate and house veterans affairs committees on the number, circumstances and placement of every member involuntarily discharged. Two smaller points. Section 35D.9: a member does not acquire residency in Marshall County by living at the home, unless discharged and otherwise meeting county residence requirements. And section 35D.11, subsection 2 and rule 801-10.35 let the department handle a member's personal funds on the member's authorization, which "shall not be a condition of admission to the home." Funding, which explains the home's incentives. Section 35D.18 puts the home on a net general fund appropriation, with VA payments, Medicaid and Medicare revenue credited to its own account as appropriated receipts, and unspent balances carried into the following fiscal year rather than reverting. For fiscal year 2026-2027 the general fund appropriation is $8,145,736 under 2026 Iowa Acts chapter 1195, and 2026 Iowa Acts chapter 1163 separately appropriated $180,000 to repair and replace sidewalks at the home.