Des Moines Senior AdvisorWhich rules govern assisted living and nursing homes in Des Moines?
Iowa state law does: assisted living programs are certified under Iowa Code chapter 231C and 481 IAC chapters 67 and 69, nursing facilities are licensed under Iowa Code chapter 135C and 481 IAC chapter 58, and the Department of Inspections, Appeals, and Licensing (DIAL) enforces both from its offices on Park Avenue in Des Moines.
Last verified: November 2026Neither the City of Des Moines nor Polk County certifies care settings. Zoning, building codes and the fire marshal touch the building; only a DIAL certificate or license lets it serve tenants or residents.
What changed in Iowa's assisted living rules in 2026?
DIAL rewrote and readopted 481 IAC chapters 67 and 69 effective March 11, 2026 (ARC 0063D and ARC 0065D), keeping the core model of two-year certification, admission and retention limits and dementia-specific programs while updating definitions and procedures.
On DIAL's current roster, 79 assisted living programs operate in the six metro counties, and 39 of them hold dementia-specific certificates.
Where do Des Moines families take a problem?
Care complaints about a certified program or licensed facility go to DIAL (online complaint portal or (515) 381-7272); residents' rights questions go to the State Long-Term Care Ombudsman at 1-866-236-1430; and abuse of a dependent adult living at home goes to Iowa HHS at 1-800-362-2178.
Call 911 first if anyone is in immediate danger. The complaints guide below explains which office handles what.
Iowa Rules: every guide
The assisted living certificate behind every Des Moines community
How the Iowa Department of Inspections, Appeals, and Licensing certifies assisted living programs in Des Moines under Iowa Code chapter 231C: the agency, the two-year certificate, fees, accreditation and monitoring.
Open the guide →How Iowa regulates memory care, and what Des Moines families should ask
Memory care in Des Moines happens in dementia-specific assisted living programs certified by DIAL. The 481 IAC 69 definition, the Global Deterioration Scale, training, awake staffing, wandering procedures and what to check.
Open the guide →Admission and transfer rules for Iowa assisted living
Iowa's assisted living admission and retention limits (481 IAC 69.23), the 28-hour part-time care rule, retention waivers, the occupancy agreement and the involuntary transfer process for Des Moines families.
Open the guide →Staffing, nurse delegation and medications in Iowa assisted living
Iowa assisted living staffing rules for Des Moines families: 24-hour on-site staff, emergency call systems, nurse delegation, manager training, medication self-administration and setup, and background checks.
Open the guide →Checking a Des Moines-area facility's state record yourself
How to check a Des Moines assisted living program or nursing facility: DIAL's Health Facilities database, the Entity, Survey Due and Assessed Fines reports, monitoring reports, and CMS Care Compare for nursing homes.
Open the guide →Where Des Moines families take a complaint or report abuse
How to file a complaint about a Des Moines assisted living program or nursing facility with DIAL, when to call Iowa's State Long-Term Care Ombudsman, and how dependent adult abuse is reported and investigated.
Open the guide →Tenant rights and the occupancy agreement in Iowa assisted living
Iowa assisted living tenant rights (481 IAC 67.3) and what the occupancy agreement must disclose under Iowa Code 231C.5 and 481 IAC 69.21: fees, services, 30-day notice of changes, transfer criteria and appeals.
Open the guide →Nursing facility oversight in Iowa: DIAL, CMS and the record
How Des Moines-area nursing facilities are licensed by DIAL under Iowa Code 135C and inspected for CMS, what CMS star ratings and state fines mean, and how families should use them.
Open the guide →Side by side
| Iowa's rules | Iowa's rules do not | |
|---|---|---|
| Assisted living | Require DIAL certification every two years | Use the word “license” for assisted living |
| Memory care | Create a dementia-specific program with extra training and awake staff | Set a numeric staff ratio |
| Inspections | Require a DIAL monitoring visit at least every 24 months | Grade or star-rate assisted living |
| Money | Let the Elderly Waiver pay for services delivered to eligible tenants | Have Medicaid pay assisted living rent |
