Nursing home surveys in Iowa have tightened up after falling behind federal standards in previous years, with inspections now occurring every 12 months on average.
In 2024, nursing homes in the state were inspected every 17.1 months on average, exceeding the federal limit of 12.9 months according to the Iowa Department of Inspections, Appeals and Licensing.
Iowa improved its record for inspecting individual facilities to at least once every 15.9 months, and the share of nursing homes missing that deadline dropped from 85.4% in 2024 to 2.8% in 2026.
Survey progress in the state is due to increased funding and more inspectors hired by the state, according to state auditor Rob Sand. Stronger staffing for inspections has made oversight more consistent, and bipartisan support from the Republican-led legislature and administration has helped greatly, Sand said.
“Because there’s more people doing it, because they’ve made that <a href="https://bitcomme.com/how-is-ai-influencing-interest-rates-investment-productivity-prices-and-more/” title=”How is AI influencing interest rates? Investment, productivity, prices, and more”>investment, that means that we are increasing the number of inspections that are getting done, and we’re increasing how frequently they’re getting done,” Sand told local reporters, including the Iowa Capital Dispatch.
But Iowa still has oversight and operational challenges to overcome – staffing shortages and the loss of nursing home capacity continue to be major headwinds.
The state currently ranks 47th in the country in nursing staff per resident. And while staff turnover has improved from 54% to 44%, it remains high compared to other states. In 2025, 15% of Iowa nursing homes were cited for inadequate staffing, according to a review in the Dispatch.
More than nine out of 20 nurses who worked at a nursing home in the previous year weren’t employed by that facility the next year, the Dispatch reported.
Since 2024, Iowa has lost 17 nursing homes and 2,000 beds, reducing access to care especially in rural parts of the state.
Companies featured in this article:
Centers for Medicare & Medicaid Services, CMS
