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Census 2025 estimates · CMS September 2026 · CDC 2020

Senior housing development in Iowa

Iowa had 283,683 residents aged 75 and older in July 2025, +16.1% since April 2020 (US +23.4%), and 80,343 aged 85 and older (+5.3%). Its 387 certified nursing homes hold 25,131 beds, 312.8 for every 1,000 people 85 and older, more than the US ratio of 222.6. Certificate of need for nursing home beds: yes; for assisted living: not listed.

Age 75+ (2025)
283,683
Growth since 2020
+16.1%
Nursing beds per 1,000 aged 85+
312.8
Assisted living beds per 1,000 aged 75+
44.1

Demand: the older population

Age groupApril 2020July 2025ChangeUS change
75 and older244,266283,683+16.1%+23.4%
85 and older76,29580,343+5.3%+11.3%

Nationally, the Census Bureau's 2023 projections have the 75+ population growing 21% from 2025 to 2030 and the 85+ population 59% from 2025 to 2035. The bureau publishes those projections for the US only, not by state.

Supply: licensed beds

SettingBedsPer 1,000 aged 75+Per 1,000 aged 85+Source
Nursing homes (Medicare or Medicaid certified)25,13188.6312.8CMS, September 2026
Residential care / assisted living12,50044.1155.6CDC survey, 2020

US: 222.6 nursing beds and 170.1 assisted living beds per 1,000 aged 85+. Assisted living beds are CDC's 2020 survey estimate, its latest with state detail, set against 2025 population, so the ratio understates any supply added since.

Certificate of need

Nursing home beds
Yes
Assisted living
Not listed
Notes
Covers nursing and "Residential care facilities". 2026 HF2635 raises thresholds

From NCSL's certificate of need table (updated April 29, 2025, covering January 2025) with later changes checked on state sites on October 24, 2026. "Not listed" means NCSL does not name assisted living, not that it is exempt. Confirm with the state health planning agency before relying on it. HUD requires a state CON for nursing home beds where the state has one (Handbook 4232.1, 2.5.EE).

Counties

The 25 counties with the most residents aged 75+, with certified nursing home beds per 1,000 aged 85+.

CountyAge 75+Since 2020Share of populationAge 85+Nursing homesBeds per 1,000 aged 85+
Polk County34,518+26.8%6.7%9,08330248.2
Linn County19,576+21.0%8.4%5,49718238.7
Scott County14,898+23.2%8.5%3,77611268.8
Black Hawk County11,068+16.1%8.4%3,06912345.1
Johnson County10,488+46.2%6.6%2,5857220.9
Dubuque County9,739+15.4%9.8%3,01412309.6
Pottawattamie County8,009+17.4%8.6%2,1347257.3
Woodbury County7,529+14.7%7.1%1,9969270
Dallas County7,512+51.8%6.3%2,0068226.8
Story County6,788+23.2%6.7%2,0207224.3
Cerro Gordo County5,059+15.1%11.9%1,5215288.6
Warren County4,654+28.5%8.1%1,3056349.4
Clinton County4,498+7.7%9.8%1,2214246.5
Des Moines County4,112+13.1%10.8%1,0793261.4
Muscatine County3,673+16.6%8.8%8994382.6
Lee County3,661+12.3%11.3%1,0446375.5
Jasper County3,621+14.5%9.5%1,0025259.5
Webster County3,503+7.0%9.5%1,1104315.3
Marshall County3,398+0.1%8.5%91951065.3
Marion County3,357+12.1%9.8%9974284.9
Sioux County2,926+11.8%8%1,0065361.8
Wapello County2,897+5.5%8.2%7433331.1
Bremer County2,718+15.1%10.7%7944277.1
Dickinson County2,572+27.3%14.2%6882183.1
Boone County2,523+12.9%9.4%7454383.9

Fastest growth in the 75+ population

  1. Jefferson County: +56.9% (2,072)
  2. Dallas County: +51.8% (7,512)
  3. Johnson County: +46.2% (10,488)
  4. Warren County: +28.5% (4,654)
  5. Dickinson County: +27.3% (2,572)
  6. Polk County: +26.8% (34,518)
  7. Scott County: +23.2% (14,898)
  8. Story County: +23.2% (6,788)
  9. Henry County: +22.0% (2,143)
  10. Linn County: +21.0% (19,576)

Counties with at least 2,000 residents aged 75+.

Fewest nursing beds per 1,000 aged 85+

  1. Johnson County: 220.9 (571 beds, 2,585 aged 85+)
  2. Story County: 224.3 (453 beds, 2,020 aged 85+)
  3. Dallas County: 226.8 (455 beds, 2,006 aged 85+)
  4. Linn County: 238.7 (1,312 beds, 5,497 aged 85+)
  5. Clinton County: 246.5 (301 beds, 1,221 aged 85+)
  6. Polk County: 248.2 (2,254 beds, 9,083 aged 85+)
  7. Pottawattamie County: 257.3 (549 beds, 2,134 aged 85+)
  8. Jasper County: 259.5 (260 beds, 1,002 aged 85+)
  9. Des Moines County: 261.4 (282 beds, 1,079 aged 85+)
  10. Scott County: 268.8 (1,015 beds, 3,776 aged 85+)

Counties with at least 1,000 residents aged 85+.

HUD Section 232 construction in Iowa

Since fiscal 2001 HUD has insured 21 new construction or substantial rehabilitation loans on care facilities in Iowa (15 assisted living, 4 nursing homes), $153.6 million of original principal, 5 of them since fiscal 2016.

  • FY2022: The Views at Marion, Marion, assisted living, $22.3 million
  • FY2022: The Willows of Marshalltown, Marshalltown, assisted living, $10.3 million
  • FY2018: Stoney Point Meadows, CEDAR RAPIDS, assisted living, $14 million
  • FY2018: The Views at Marion, Marion, assisted living, $22.3 million
  • FY2017: The Willows of Marshalltown, Marshalltown, assisted living, $10.3 million

Planning a building in Iowa? Model the budget, lease-up and a HUD 232 construction loan.

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Sources: Census Bureau Vintage 2025 county population estimates; CMS Nursing Home Provider Information (September 2026); CDC/NCHS National Post-acute and Long-term Care Study (2020); HUD Office of Healthcare Programs endorsement database (data run 07/08/2026); NCSL. Absorption is operated by Janover Capital LLC and is not affiliated with any of them. Methodology.