A new scorecard from the AARP concludes Iowa is among the top states in the nation for the quality of care provided to its senior citizens, but Iowa’s in the middle of the pack when it comes to having options other than nursing home care available for the elderly.

Enid Kassner, an AARP researcher, says 70 percent of state Medicaid spending for the elderly is paying for nursing home care.

“If the state wanted to target its efforts on getting more people into home care and out of nursing homes, ultimately it will save the state money,” Kassner says.

Kassner cites research which indicates a state can serve three people with in-home care for what it costs to pay for one person in a nursing home.

The AARP ranks Iowa eighth in the supply of “assisted living” communities, but there is an overall lack of services available to Iowans who want to stay in their own home with help from a visiting nurse, for example.

“We know that for most people, their first choice is not to live in a nursing home,” Kassner says, “and if they can stay in their own homes, that is the preference of nearly everyone.”

Iowa ranked sixth, overall, on the support that’s available for seniors, but Iowa was 22nd among the states when it came to affordability and access to services for seniors and 22nd for the living choices available to seniors. According to the report, more than four-thousand Iowa nursing home residents have “low care” needs and could be better served with in-home care or by moving to assisted living.

Iowa ranked fifth in the county on quality of life and quality of care for the elderly.