Other senior care options in Iowa:

Page 26 of Best Assisted Living in Iowa

Why trust this guide? Our editorial team analyzed 310 assisted living communities in IA using IA Dept. of Inspections, Appeals & Licensing (DIAL) data, inspection records, complaints, amenities, and facility-level details. How we rank assisted living in IA
Reviewed by
Last updated
Jul 2026
We analyzed
310 homes
Other senior care options in Iowa:
Avg Monthly Cost: $5,500The average monthly cost across facilities in Iowa. Reflects published or estimated base rates and can vary with care level, room type, and amenities. Individual facilities can vary widely from this average.
National Average: $5,600
Avg Walk Score: 47/ 100The average Walk Score across facilities in Iowa. A third-party neighborhood walkability score (0–100) measuring convenience and context, not healthcare quality. Individual facilities can vary widely from this average.
National Average: 50/ 100
Avg No. of Beds: 72The average licensed bed capacity across facilities in Iowa. Individual facilities can vary widely from this average.
National Average: 90

Compare Assisted Living around Iowa

Info below is compiled from the IA Dept. of Inspections, Appeals & Licensing (DIAL), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.

Oaknoll Retirement Residence
AL
IL
NH
Iowa City (Roosevelt)
70
Facility 70
IA AVG 72
Rank #156 / 404
No
33
Facility 33
IA AVG 47
Rank #344 / 505
Private Rooms
49
Facility 49
IA AVG 19
Rank #15 / 286
81.4% -12
2
Facility 2
IA AVG 7
Rank #55 / 295
1
Facility 1
IA AVG 0.9
Rank #201 / 295
Green Hills Retirement Community
AL
IL
MC
NH
SNF
Ames (Hamilton Drive)
56
Facility 56
IA AVG 72
Rank #232 / 404
Yes
18
Facility 18
IA AVG 47
Rank #430 / 505
1 Bed / 2 Bed
40
Facility 40
IA AVG 19
Rank #25 / 286
78.6% -11
2
Facility 2
IA AVG 7
Rank #55 / 295
3
Facility 3
IA AVG 0.9
Rank #249 / 295
Sunrise Retirement Community
AL
IL
MC
NH
RC
SNF
Sioux City
74
Facility 74
IA AVG 72
Rank #136 / 404
Yes
22
Facility 22
IA AVG 47
Rank #411 / 505
Studio
52
Facility 52
IA AVG 19
Rank #5 / 286
90.5% A+25
3
Facility 3
IA AVG 7
Rank #89 / 295
6
Facility 6
IA AVG 0.9
Rank #285 / 295
Mill Pond
AL
IL
MC
NH
SNF
Ankeny
60
Facility 60
IA AVG 72
Rank #213 / 404
Yes
16
Facility 16
IA AVG 47
Rank #438 / 505
Studio / 1 Bed / 2 Bed
23
Facility 23
IA AVG 19
Rank #106 / 286
98.3% -16
5
Facility 5
IA AVG 7
Rank #146 / 295
1
Facility 1
IA AVG 0.9
Rank #201 / 295
Wesley Acres
AL
ADC
IL
MC
NH
SNF
Des Moines (Greenwood)
80
Facility 80
IA AVG 72
Rank #105 / 404
Yes
72
Facility 72
IA AVG 47
Rank #89 / 505
-- 91.3% -21
8
Facility 8
IA AVG 7
Rank #202 / 295
3
Facility 3
IA AVG 0.9
Rank #249 / 295
Deerfield Health Care Center
AL
NH
IL
RESC
Urbandale
30
Facility 30
IA AVG 72
Rank #388 / 404
Yes
5
Facility 5
IA AVG 47
Rank #487 / 505
-
21
Facility 21
IA AVG 19
Rank #126 / 286
73.3% A+19
3
Facility 3
IA AVG 7
Rank #89 / 295
3
Facility 3
IA AVG 0.9
Rank #249 / 295
Terrace Glen Village
AL
IL
NH
SNF
Marion (Flynn)
40
Facility 40
IA AVG 72
Rank #323 / 404
Yes
14
Facility 14
IA AVG 47
Rank #443 / 505
-
8
Facility 8
IA AVG 19
Rank #201 / 286
95.0% A13
0
Facility 0
IA AVG 7
Rank #1 / 295
3
Facility 3
IA AVG 0.9
Rank #249 / 295
Meth Wick Community
AL
IL
MC
NH
RC
SNF
Cedar Rapids (The Meth-Wick Community)
69
Facility 69
IA AVG 72
Rank #167 / 404
No
23
Facility 23
IA AVG 47
Rank #405 / 505
-- 81.4% ----
Heart of Siouxland Senior Care
AL
Sioux City
-No
66
Facility 66
IA AVG 47
Rank #118 / 505
-------
Simpson Memorial Home
AL
IL
NH
SNF
West Liberty (North Miller Street)
55
Facility 55
IA AVG 72
Rank #238 / 404
No
41
Facility 41
IA AVG 47
Rank #287 / 505
-- 58.2% -18
3
Facility 3
IA AVG 7
Rank #89 / 295
4
Facility 4
IA AVG 0.9
Rank #270 / 295
St Francis Manor
AL
HOS
NH
SNF
Grinnell
78
Facility 78
IA AVG 72
Rank #119 / 404
No
82
Facility 82
IA AVG 47
Rank #39 / 505
-
49
Facility 49
IA AVG 19
Rank #15 / 286
69.2% -10
4
Facility 4
IA AVG 7
Rank #121 / 295
0
Facility 0
IA AVG 0.9
Rank #1 / 295
Friendship Village
AL
IL
MC
NH
SNF
Waterloo
72
Facility 72
IA AVG 72
Rank #143 / 404
Yes
52
Facility 52
IA AVG 47
Rank #202 / 505
2 Bed / 3 Bed
50
Facility 50
IA AVG 19
Rank #9 / 286
91.7% -17
0
Facility 0
IA AVG 7
Rank #1 / 295
3
Facility 3
IA AVG 0.9
Rank #249 / 295
Prairie Vista Village
AL
IL
NH
SNF
South Altoona
68
Facility 68
IA AVG 72
Rank #170 / 404
Yes
29
Facility 29
IA AVG 47
Rank #372 / 505
-
12
Facility 12
IA AVG 19
Rank #178 / 286
50.0% A7
1
Facility 1
IA AVG 7
Rank #31 / 295
0
Facility 0
IA AVG 0.9
Rank #1 / 295
Mount Carmel Bluffs
AL
IL
MC
NH
SNF
Dubuque (South Switch Junction)
60
Facility 60
IA AVG 72
Rank #213 / 404
No
2
Facility 2
IA AVG 47
Rank #499 / 505
1 Bed / 2 Bed
5
Facility 5
IA AVG 19
Rank #233 / 286
93.3% -10
2
Facility 2
IA AVG 7
Rank #55 / 295
2
Facility 2
IA AVG 0.9
Rank #232 / 295
Mayflower Home
AL
IL
MC
NH
SNF
Grinnell
40
Facility 40
IA AVG 72
Rank #323 / 404
No
82
Facility 82
IA AVG 47
Rank #39 / 505
-- 77.5% -11
3
Facility 3
IA AVG 7
Rank #89 / 295
0
Facility 0
IA AVG 0.9
Rank #1 / 295
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MJ Estates

411 S. Carthage Street, Exira, IA 50076
Overview of Mj Estates

Enjoy your best years at Mj Estates, a blissful haven in Exira, IA, offering assisted living. With 37 specially designed and cozy accommodations, residents are guaranteed the utmost comfort and safety. A compassionate and well-trained team provides top-notch care tailored to their personal needs around the clock.

Residents are encouraged to make new friends and have fun with a jam-packed calendar of engaging activities and enriching programs that highlight their interests and capabilities. Delicious and well-balanced meals are also served to satisfy residents’ dietary needs and preferences. Medication management is also provided to ensure residents will not miss taking their medicines. The community is ideal for those seeking a blissful retirement, especially with its warm and nurturing environment.

Contact MJ Estates

Overview of Kosgrove Estates

Conveniently located in the thriving neighborhood of Sioux Center, IA, Kosgrove Estates is a blissful haven that offers assisted living. Committed to improving residents’ welfare, a compassionate and well-trained team provides top-notch care tailored to residents’ unique needs around the clock. Housekeeping and other household chores are also taken care of, ensuring that older adults have more time to do the things they love.

A jam-packed calendar of enriching activities and fun recreational programs is conducted to keep residents active and socially connected. Mealtimes are something to look forward to, with delicious and well-balanced dining options. The community is ideal for those needing assistance to live comfortably in retirement, especially with its dedicated services and well-maintained amenities.

Contact Kosgrove Estates

Overview of Edencrest at Timberline

Edencrest at Timberline is a 120-bed senior living community at 14001 Douglas Parkway in Urbandale, Iowa. Managed by Geoff Counasse and part of the Highmark Senior Living portfolio, the facility serves Polk County under license S0471, valid through May 2027. Current occupancy stands at approximately 54% with 65 residents, a figure that reflects its status as a recently established campus building its census. The location is categorized as car-dependent with a Walk Score of zero, though the facility provides scheduled transportation for residents.

Since its licensing in 2023, the facility has undergone one recertification inspection in October 2025, which identified only a single deficiency, a rate 96% lower than the state average. This isolated finding involved staff management of a resident’s monitoring device, but the facility achieved a citations-per-inspection rate of zero for all other evaluated categories. There are no documented fines or enforcement actions in the community’s history.

Clinical care is delivered by a 24/7 on-site team that includes a Director of Nursing and professional caregivers specialized in memory care. Services cover a full continuum, including independent living, assisted living, and high-acuity support for diabetes and incontinence. Memory care starts at approximately $5,600 monthly, while general assisted living begins at $4,400, covering personalized health plans and medication management.

The residential environment features modern apartments with move-in assistance and access to extensive shared amenities. Residents have access to a fitness center, walking trails, a library, and a full-service salon and spa. Social programming includes daily wellness classes, arts and crafts, and curated restaurant-style dining with specific dietary accommodations. The community is pet-friendly and provides private courtyards for outdoor recreation.

Families seeking a newer, high-amenity campus with a specialized memory care program may find this community appropriate. Families should ask directly about the current staff training protocols for resident monitoring and confirm the latest monthly rates for specific apartment floor plans before making a placement decision.

Contact Edencrest at Timberline

Overview of Birdee Cottage Al and Mc

Birdee Cottage Al and Mc is a 33-bed, family-owned senior living facility at 2221 Fairway Lane in Waterloo, Iowa. Administered by Kim Meyer, the community serves Black Hawk County under license S0455, which is active through November 17, 2027. The facility currently reports an occupancy rate of 52% with 17 residents. With a Walk Score of 2, the location is considered car-dependent for all daily errands.

State monitoring from the Iowa Department of Inspections, Appeals, and Licensing shows a notable trend of regulatory improvement. Since 2022, the community has recorded 10 total deficiencies across four inspections, an average of 2.5 per year which is 63% below the state annual average. While an initial 2022 visit identified nine violations, a February 2025 complaint investigation resulted in a citations-per-inspection rate of zero. The most recent evaluation in September 2025 identified one deficiency regarding the omission of physician-recommended titration plans in a resident’s service plan.

Professional care is provided in a residential setting that includes private bedrooms, nursing services, and camera safety systems. Clinical support covers medication management and special diet accommodations, though the facility operates on a private-pay basis only and does not accept Medicare or Medicaid. Early 2022 records cited concerns with wound care documentation and medication administration errors, but subsequent reviews indicate these foundational issues were addressed through corrective actions.

The campus environment is designed as an intimate, small-scale community emphasizing home-cooked meals and personalized attention. Shared features include grab bar handles throughout the facility and snacks available for residents during the day. Historical gaps from the facility’s first year involved non-functional alarm systems and failures to complete staff background checks prior to hiring, though recent findings suggest more consistent operational oversight.

Prospective residents should evaluate the facility’s recent improvement in compliance alongside its private-pay model. It is recommended to verify that all service plans now include comprehensive physician recommendations and to observe the current staff-to-resident interaction during an on-site visit. Interested individuals can contact the administrator to discuss current availability and specific care protocols as they plan for 2026.

Contact Birdee Cottage AL and MC

Overview of The Summit of Bettendorf Mc

The Summit of Bettendorf Mc is a 32-unit memory care assisted living program at 4699 53rd Avenue in Bettendorf, Iowa. Part of the Wellspire Living community and administered by Monica Reyes, the facility is a dementia-specific program serving Scott County residents with cognitive impairments. The campus provides 24-hour medical monitoring and accepts Medicare, featuring a purpose-built environment that has seen steady growth since its 2022 opening.

State and federal records currently assign the facility a 5-star overall rating, placing it in the highest performance tier available. Between 2022 and 2025, regulatory inspections yielded an average of 3.0 deficiencies per year, which is 32% below the Iowa state average. While an October 2024 renewal survey concluded with zero deficiencies, a March 2025 report identified three citations related to pre-admission evaluations and service plan updates. Historical investigations from 2022 noted two elopement-related incidents that were subsequently resolved through security and training upgrades.

Professional care is delivered under a staffing model that provides 4 hours 41 minutes of daily nursing time per resident, performing 23% above the Iowa average. Registered Nurse (RN) presence is currently 54 minutes per resident day, which exceeds the state mean by approximately 22%. Clinical outcomes for short-stay residents are notable, with 59.6% successfully returning to the community and a major injury fall rate 30% better than the state average. However, the rehospitalization rate for the facility is 28.5%, which performs below the Iowa average.

The campus environment provides an upscale residential atmosphere with a state-of-the-art wellness center, a golf simulator, and a rooftop bar. Residents benefit from multiple on-campus dining venues, a professional salon and barbershop, and guest rooms for visiting family members. Shared outdoor amenities include walking paths and firepits, while the clinical model incorporates on-site physical, occupational, and speech therapy.

Interested individuals should evaluate the current elopement prevention systems and service plan review processes during a facility tour. It is advisable to ask the administrator for specific details regarding the corrective actions implemented after the 2025 pre-admission evaluation findings to ensure that current clinical protocols meet the resident’s specific memory care needs.

Contact The Summit of Bettendorf MC

Edencrest at Riverwoods

2210 E Park Ave, Des Moines, IA 50320
Overview of Edencrest at Riverwoods

Ideally set in the tranquil neighborhood of East Park Avenue, Des Moines, IA, is the reliable senior living community of Edencrest at Riverwoods that provides assisted living and memory care. Experience the highest quality of care and support with a compassionate and responsible team caring for residents’ needs and preferences around the clock. Featuring different levels of care for individuals with dementia and other memory-related needs, the community promotes a vibrant and welcoming environment where residents thrive.

Elevate your retirement with fun recreation and wellness programs, highlighting your interests and strengths. Delightful and healthy meals are also provided to foster comfort and meet dietary needs. With beautiful courtyards and pet-friendly spaces, residents enjoy a peaceful and happy retirement.

Contact Edencrest at Riverwoods

Community Memorial AL

233 North 8Th Avenue West, Hartley, Ia 513461077
Overview of Community Memorial Al

Community Memorial Assisted Living is a 32-bed senior living community at 233 North 8th Avenue West in Hartley, Iowa. Managed by Kay Wynja and part of the Community Memorial Health Center campus, the facility provides assisted living, skilled nursing, and memory care under a license valid through July 2026. Current data indicates a census of five residents, representing a 16% occupancy rate, which is below the state average of 75.4%. The location holds a Walk Score of 43, suggesting that most errands require transportation provided by the facility.

Regulatory records from the Iowa Department of Inspections, Appeals, and Licensing reflect a strong compliance history over the last 14 years. The most recent recertification in July 2025 resulted in a citations-per-inspection rate of zero. While a 2015 review noted a citation regarding the timeliness of tenant evaluations, the facility has recorded no deficiencies in its last five major surveys. During this period, there have been no documented fines, license suspensions, or enforcement actions.

Clinical care is supported by 24-hour on-site staffing and an integrated medical clinic with X-ray services. Professional services include medication management, health monitoring, and specialized physical, occupational, and speech therapies. Residents benefit from priority admission to the adjacent skilled nursing and rehabilitation wing if health needs change. Staffing metrics for the health center show nurse hours exceeding state averages, providing four hours and two minutes of care per resident daily.

The residential environment includes private apartments with kitchenettes, emergency call pendants, and access to a whirlpool bathing suite. Shared amenities feature a beauty salon, garden patio, and communal dining areas where three meals are served daily. Housekeeping, laundry, and all utilities except telephone service are included in the monthly fees. Social engagement is facilitated through a rotation of planned recreational activities and 24-hour visiting availability.

Prospective residents seeking a small-scale community with an on-site medical clinic and a long-term record of regulatory excellence may find this campus suitable. Families should ask directly about the specific staffing ratios for the memory care neighborhood and confirm current availability for private suites before making a placement decision.

Contact Community Memorial AL

Primrose Retirement Community

1801 East Kanesville Blvd, Council Bluffs, IA 51503
Overview of Primrose Retirement Community

Primrose Retirement Community is a 64-bed senior living campus at 1801 East Kanesville Boulevard in Council Bluffs, Iowa. Administered by Tiffany Eggett and certified as a dementia-specific assisted living program, the facility serves Pottawattamie County with a clinical continuum ranging from independent townhome villas to specialized memory care. The campus maintains a current occupancy rate of approximately 55%, with private room rates starting near $4,900 per month.

State inspection records show a deficiency rate that is 6% more favorable than the Iowa state average. While a May 2024 recertification audit was completed with zero deficiencies, a November 2024 follow-up cited three concerns regarding service plan accuracy and memory care unit door alarms. Long-term data indicate a per-inspection citation rate that is 17% below the state mean, though the community remains a private-pay facility and does not currently participate in Medicare or Medicaid.

On-site nursing, personal aid, and therapy are managed through a 24-hour staffing framework. This model emphasizes individualized cognitive support, addressing various stages of memory loss within a secure environment. Though residents utilize regular wellness monitoring and restorative programs, the rural-style location is car-dependent with a Walk Score of zero. Notably, the facility has maintained its license without any suspensions since it began operations in 2008.

A home-like residential setting is supported by three daily meals and specialized social spaces like a 1950s-style ice cream parlor. Common areas available to residents include a chapel, wellness center, billiard room, and library. The service package also features weekly housekeeping, laundry, and local transportation, alongside pet-friendly housing options that offer quiet views. For convenience, basic cable and Wi-Fi access are fully integrated into the monthly residency costs.

Interested individuals should examine the current protocols for service plan updates and perimeter security during a tour of the grounds. It is recommended to consult with the administrator regarding the specific remedies applied to the 2024 citation findings and to ensure current staffing ratios are sufficient for the resident’s 2026 care requirements.

Contact Primrose Retirement Community

Overview of Independence Village of Pella

Situated in Pella, IA, Independence Village of Pella is a reliable senior living community that offers Independent Living, Assisted Living, and Memory Care. The community features an array of beautifully designed accommodations, ranging from studios to one-bedroom and two-bedroom apartments, providing a comfortable living space to residents. Care needs are fully met with personalized care plans and professionally trained employees available 24/7 to provide care and assistance.

There’s no shortage of enriching things to do with a vibrant calendar of activities, events, and programs offered by the community. Dining experience is improved with chef-prepared meals that are carefully curated to satisfy unique dietary needs and food preferences. Residents never have to worry about chores with housekeeping, laundry services, and other supportive services provided by a dedicated team. Here, residents have what they need to live a carefree and fulfilling lifestyle.

Contact Independence Village of Pella

Overview of Cottage Grove Place

Cottage Grove Place is an 82-bed healthcare facility at 2115 First Avenue SE in Cedar Rapids, Iowa. Administered by Jennifer Snook and operated as a voluntary non-profit by Life Care Services LLC, the campus serves Linn County with a license valid through February 2027. Current data shows a census of 37 residents, representing a 45% occupancy rate, which is below the Iowa average of 75.4%. The location earns a high Walk Score of 79, placing it near city center amenities and pharmacies.

Monitoring data from the Iowa Department of Inspections, Appeals, and Licensing shows a history of lower-than-average citations. Over two decades, the facility has recorded an annual deficiency rate 31% lower than state benchmarks, averaging 0.9 violations per year. While the January 2026 inspection concluded with four health citations—focusing on medication administration and service plan documentation, the assisted living program achieved a citations-per-inspection rate of zero in its most recent certification. There are no documented fines or severe penalties in the past three years.

Clinical care is delivered by a team providing 4 hours and 22 minutes of nursing time per resident daily, exceeding the Iowa average by approximately 15%. Professional services emphasize short-term recovery, with physical therapy staffing levels 150% above state averages. While short-stay outcomes are strong, quality measures for long-term residents show historical challenges in functional mobility and pressure ulcer prevention, which occur at rates above the state benchmark. The facility accepts a combination of private pay and Medicare, which accounts for 40% of new admissions.

The residential environment is part of a Continuing Care Retirement Community, featuring private suites and a full therapy gym. Shared amenities include a woodworking shop, a private movie theater, a library, and landscaped courtyards. Social programming is provided through a Life Enrichment department, offering cultural workshops and educational events. The community is pet-friendly and includes emergency response systems in all apartments.

Prospective representatives seeking specialized physical therapy and short-term rehabilitation may find this campus appropriate. Families should ask directly about the specific interventions implemented to address long-term functional decline and request current data on nurse aide turnover rates before making a placement decision.

Contact Cottage Grove Place

Weighting overview

  • 35%
    Resident Experience
  • 25%
    Regulatory
  • 15%
    Visual Media
  • 10%
    Website
  • 10%
    Stability
  • 5%
    Environment
01

Resident & Family Experience 35%

The single largest share of every ranking. Aggregated review sentiment and volume from major platforms — the closest signal to real resident experience.

  • Includes
  • Review Sentiment
  • Review Volume
02

Regulatory & Safety Record 25%

State inspection records, citations, and complaint visits. We weight per-inspection rates more heavily than raw counts.

  • Includes
  • State Inspections
  • Citations/Inspection
  • % Inspections w/ Citations
  • Complaint Visits
  • Accreditations
  • BBB Rating
03

Visual Media & Transparency 15%

Communities that publish high-quality visuals give families a real preview. No photos or tours = a negative transparency signal.

  • Includes
  • Video Tours
  • Virtual Walkthroughs
  • Photo Quantity
  • Photo Quality
04

Website & Operator Transparency 10%

Site quality and whether the operator publishes basic accountability information — staff names, contact details, ownership.

  • Includes
  • Website Content
  • Mobile Usability
  • Staff Info Available
  • Owner Info Available
05

Community Stability 10%

Operational signals indicating whether a community is well-run and meeting demand.

  • Includes
  • Occupancy Rate
  • Bed Options
06

Environment & Pricing 5%

Walkability and pricing transparency. Walk Score is weighted higher for Independent Living than for Memory Care, where most residents do not leave unaccompanied.

  • Includes
  • Walk Score
  • Pricing Transparency
No paid rankings Communities cannot pay to influence placement.
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Frequently Asked Questions about Assisted Living in Iowa

What's the difference between assisted living and memory care in Iowa?

Assisted living in Iowa supports residents with daily activities (bathing, dressing, medication management) while preserving independence. Memory care is a specialized form of assisted living for residents living with Alzheimer's or dementia, and adds 24/7 secured environments, dementia-trained staff, and structured routines designed to reduce confusion and wandering.

What's the difference between assisted living and a nursing home in Iowa?

Assisted living in Iowa is a residential model focused on housing, hospitality, and help with daily activities. Nursing homes (skilled nursing facilities) provide 24/7 medical care from licensed nurses for residents with significant health needs, and are regulated more strictly under both state and federal CMS rules.

Does Iowa Medicaid cover assisted living?

Iowa Medicaid does not directly pay room-and-board for assisted living, but most states (including Iowa) offer Home and Community-Based Services (HCBS) waivers that can offset the cost of care services delivered inside a licensed community. Eligibility, waitlists, and covered services vary — check directly with the state Medicaid agency.

What is assisted living?

Assisted living combines private or semi-private apartments with help on activities of daily living (meals, bathing, dressing, medication management) and a social calendar — for residents who need some support but do not need 24/7 medical care.

How many assisted living facilities are listed on this page?

This page features 310 assisted living facilities in Iowa. Use the filters and comparison tools above to compare ratings, amenities, and pricing.

How do I choose the right assisted living facility in Iowa?

Start by matching the level of care offered to the resident's current and anticipated needs, then compare licensing status, staff-to-resident ratios, recent inspection results, and pricing. Tour at least two or three communities in Iowa, talk to current residents and families, and confirm what is included in the base rate versus billed as add-on services.

What should I look for when visiting assisted living facilities in Iowa?

Pay attention to staff interactions with residents, cleanliness and odor, food quality at meal times, the activity calendar, and how questions about pricing and care plans are answered. Ask to see the most recent state inspection report, the move-out / level-of-care-change policy, and a sample monthly bill that lists every fee.