Iowa Code ch. 231C § 231C.5
Written occupancy agreement required
Operative Text
1. An assisted living program shall not operate in this state unless a written occupancy agreement, as prescribed in subsection 2, is executed between the assisted living program and each tenant or the tenant’s legal representative, prior to the tenant’s occupancy, and unless the assisted living program operates in accordance with the terms of the occupancy agreement. The assisted living program shall deliver to the tenant or the tenant’s legal representative a complete copy of the occupancy agreement and all supporting documents and attachments and shall deliver, at least thirty days prior to any changes, a written copy of changes to the occupancy agreement if any changes to the copy originally delivered are subsequently made. 2. An assisted living program occupancy agreement shall clearly describe the rights and responsibilities of the tenant and the program. The occupancy agreement shall also include but is not limited to inclusion of all of the following information in the body of the agreement or in the supporting documents and attachments: a. A description of all fees, charges, and rates describing tenancy and basic services covered, and any additional and optional services and their related costs. b. 1. A statement regarding the impact of the fee structure on third-party payments, and whether third-party payments and resources are accepted by the assisted living program. 2. The occupancy agreement shall specifically include a statement regarding each of the following: a. Whether the program requires disclosure of a tenant’s personal financial information for occupancy or continued occupancy. b. The program’s policy regarding the continued tenancy of a tenant following exhaustion of private resources. c. Contact information for the department of health and human services and the senior health insurance information program to assist tenants in accessing third-party payment sources. c. The procedure followed for nonpayment of fees. d. Identification of the party responsible for payment of fees and identification of the tenant’s legal representative, if any. e. The term of the occupancy agreement. f. A statement that the assisted living program shall notify the tenant or the tenant’s legal representative, as applicable, in writing at least thirty days prior to any change being made in the occupancy agreement with the following exceptions: 1. When the tenant’s health status or behavior constitutes a substantial threat to the health or safety of the tenant, other tenants, or others, including when the tenant refuses to consent to relocation. 2. When an emergency or a significant change in the tenant’s condition results in the need for the provision of services that exceed the type or level of services included in the occupancy agreement and the necessary services cannot be safely provided by the assisted living program. g. A statement that all tenant information shall be maintained in a confidential manner to the extent required under state and federal law. h. Occupancy, involuntary transfer, and transfer criteria and procedures, which ensure a safe and orderly transfer. i. The internal appeals process provided relative to an involuntary transfer. j. The program’s policies and procedures for addressing grievances between the assisted living program and the tenants, including grievances relating to transfer and occupancy. k. A statement of the prohibition against retaliation as prescribed in section 231C.13. l. The emergency response policy. m. The staffing policy which specifies if nurse delegation will be used, and how staffing will be adapted to meet changing tenant needs. n. In dementia-specific assisted living programs, a description of the services and programming provided to meet the life skills and social activities of tenants. o. The refund policy. p. A statement regarding billing and payment procedures. 3. Occupancy agreements and related documents executed by each tenant or the tenant’s legal representative shall be maintained by the assisted living program in program files from the date of execution until three years from the date the occupancy agreement is terminated. A copy of the most current occupancy agreement shall be provided to members of the general public, upon request. Occupancy agreements and related documents shall be made available for on-site inspection to the department upon request and at reasonable times.
Iowa Code ch. 231C § 231C.5 requires that every assisted living program in Iowa execute a written occupancy agreement with each tenant—or the tenant's legal representative—before the tenant moves in. The agreement must clearly spell out fees, services, transfer procedures, grievance policies, staffing practices, and other key terms. If the program later changes the agreement, it must deliver written notice of those changes at least thirty days in advance, with limited exceptions for health or safety emergencies. Completed agreements must be kept on file for three years after termination and made available to the public and state inspectors upon request.
Plain English — not legal advice.
Operators of assisted living programs subject to Iowa Code ch. 231C § 231C.5 generally ensure that a fully executed written occupancy agreement is in place before any tenant takes occupancy. Compliant programs maintain agreements that address all required elements—including fee structures, third-party payment policies, transfer criteria, grievance procedures, and staffing policies—and deliver complete copies to tenants or their legal representatives at signing. When changes to the agreement become necessary, compliant programs provide written notice at least thirty days in advance, except in defined health or safety emergencies, and retain all executed agreements and related documents for at least three years after termination.
General guidance for property managers — not legal advice for your specific situation. Consult an attorney for advice on your case.
Under Iowa Code ch. 231C § 231C.5, tenants in assisted living programs have the right to receive a complete written occupancy agreement—including all attachments—before moving in, and to receive written notice at least thirty days before most changes take effect. The agreement must describe fees, services, transfer and grievance procedures, and the program's anti-retaliation policy, among other protections. Tenants or their legal representatives who believe an agreement is incomplete, was not provided, or that changes were made without proper notice may consider contacting the Iowa Department of Health and Human Services, reaching out to the Senior Health Insurance Information Program referenced in the agreement itself, or consulting a tenant-rights or elder-law organization for guidance on available options.
General guidance for tenants — not legal advice for your specific situation. Consult a tenant-rights organization or attorney for advice on your case.
Generated October 18, 2026 — auto-generated, not yet human-reviewed. See /transparency for methodology.
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