Healthcare (Long-Term Care)

SF 526 requires Iowa nursing facilities to spend at least 70% of their total income on resident care goods/services (like staff salaries, medications, and supplies) and at least 40% specifically on direct care staff salaries, beginning January 1, 2026. Facilities must also send any income exceeding 105% of their expenses to a new "Aging Iowans Care Fund" in the state treasury. The bill prohibits new licenses or license renewals for non-compliant facilities and allows waivers for "unexpected circumstances" after review by the licensing department and the long-term care ombudsman. This directly affects all Iowa nursing facilities seeking licensing or renewal after 2025.

This bill requires Iowa's Department of Health to hold semiannual joint training sessions for nursing home inspectors and facilities. The sessions must cover the top three federal citation issues from the previous year and include information about the federal Jimmo v. Sebelius settlement, which clarifies that Medicare coverage for skilled nursing/therapy depends on a patient's need for care - not their potential to improve. The training must involve the state long-term care ombudsman and nursing facility provider associations. This policy change directly affects nursing home inspectors, facilities, and Medicare beneficiaries by aligning state inspections with federal coverage policy.

This bill allows Iowa individual income taxpayers to deduct expenses paid to licensed nursing facilities (under Chapter 135C) for health-related care and services, provided those costs weren't already deducted for federal tax purposes. It directly affects Iowans paying for nursing care who file state income tax returns. The deduction applies to expenses incurred for health services, not general living costs at the facility. The law includes retroactive application, making it effective for tax years beginning on or after January 1, 2025.