Bethany Heights Assisted Living-Welcome Home!

Sponsored by Bethany Lutheran Home, Bethany Heights Assisted Living offers assisted living apartment homes and additional services to meet your individual needs. You can expect the same level of quality, value, and care at Bethany Heights that other area seniors have been enjoying with us for many years. Bethany Heights is a nonprofit organization, and seniors of all faiths are welcome.
Happy seniors mixing ingredients

Services Included in Monthly Rent

  • Breakfast, lunch, and a restaurant style evening meal ( 3 meals a day)
  • Van transportation, including Sunday church
  • All utilities paid
  • Social and recreational activities
  • Housekeeping services weekly
  • Free laundry facilities
  • Basic Cox cable services (Channels 03-220)
  • 24 hour on-call maintenance services
  • Free Wi-Fi
  • Emergency response pendant
  • Once per day “I’m OKAY” check with evening meal

Features and Amenities Available

  • Living room with big screen TV
  • Community room
  • Billiards room
  • Snack shop
  • Library with computer and internet access
  • Landscaped outdoor courtyard
  • Fireside room
  • Community Channel 1960

grandfather and grandchildren reading a book

Additional Services Available at a Fee

  • Personalized nursing care
  • Meal tray services to rooms
  • Guest meals
  • Garage parking
  • Local hotel discounts available
  • Beauty/Barber shop services
  • Additional housekeeping if needed
  • Whirlpool bath
  • Phone service

Testimonials

“Bethany Heights has been my home for six years. Every day is a new experience. I like it here!”

-M.E.R.

“Working at Bethany Heights has been such an amazing experience!  The folks who live in our community are so thoughtful, helpful, and simply amazing.  They say you never work a day in your life when you love your job and I am loving mine!”

– C.M.G.

Application for Admission:

Bethany Lutheran Home
Bethany Heights Assisted Living

  • Name
  • Date of Birth
  • Place of Birth
  • Home Address, City, State, Zip
  • Home Phone Number
  • Responsible Party/ Family/ Friends (The first person listed is the emergency contact. )

  • Emergency Contact Name
  • Emergency Contact Address
  • Emergency Contact Address Work & Home Phone
  • Emergency Contact Relationship
  • Responsible Party #1 Name
  • Responsible Party #1 Work & Home Phone
  • Responsible Party #1 Relationship
  • Responsible Party #2 Name
  • Responsible Party #2 Address
  • Responsible Party #2 Work & Home Phone
  • Responsible Party #2 Relationship
  • Responsible Party #3 Name
  • Responsible Party #3 Address
  • Responsible Party #3 Work & Home Phone
  • Responsible Party #3 Relationship
  • Responsible Party #4 Name
  • Responsible Party #4 Address
  • Responsible Party #4 Work & Home Phone
  • Responsible Party #4 Relationship
  • Primary physician: (Must be licensed in Iowa)
  • Alternative Physician
  • Hospital
  • Dentist
  • Psychiatrist
  • Optometrist
  • Funeral Home
    Pharmacy
  • Date of most recent physical exam or hospitalization:
  • Height
  • Weight
  • Insurance Information

  • Medicare # (orRailRoad Medicare #)
  • Social Security #
  • Medicaid #
  • Authorization #
  • Caseworker
  • Effective Date
  • County
  • Supplemental Medical Insurance Company Policy #
  • Long Term Care Insurance Company Policy #
  • Social History

    Do you have: Please check all that apply and attach documents. Copies are acceptable
  • Spouse’s name, whether living or not:
  • Wedding Anniversary date
  • Date of death of spouse if applicable
  • Have you been or are you now a resident of another nursing home?
  • Where? When?
  • Church or religious preference:

  • Congregation
  • Clergy
  • Address
  • Phone #
  • Branch of Service
  • Past or Present occupation:
  • Past or Present interests or hobbies:
  • Do you have any special needs or requests?
  • Please tell us about your needs. Check all that apply.

  • Daily Routine

      Can wash self
      Conversation
      Can dress self
      Can feed self
      Has control of bladder
      Has control of bowel
      Can walk independently or with walker
      Can transfer self
      Can propel own wheelchair
      Requires splint or brace
      Wears a prosthesis
  • Type of Prosthesis
  • Health

      Is diabetic
      Has heart problems
      Has nervous problems
      Has memory problems
      Has memory problems
      Has allergies
      Smokes
      Uses alcohol
      Needs special diet
      Has unhealed wounds
      Has own teeth
  • Allergies:
  • Sensory

      Can hear
      Can see
      Expresses self well
      Can follow simple commands
      Is easily agitated
      Sleeps all night
      Wanders or paces
      Angers easily
      Cries frequently
      Naps during the day
      Bothered by noise
  • Social

      Enjoys larger groups
      Enjoys smaller groups
      Likes being with others
      Likes to be alone
      Has sense of humor
      Enjoys being active
      Prefers quiet activity
  • Preferences

      T.V./Movies
      Pets
      Van rides
      Leading
      Table Games
      Parties
      Cards
      Shopping trips
      Field trips
      Church
      Puzzles
      Painting
      Newspapers
      Playing musical instrument
      Conversations
      Group Participation
      Singing
      Handicrafts
      Musical Programs
      Books on Tape
      Music
    • Style
  • Other
  • To whom shall we send the monthly bill and other business mail from Bethany Lutheran Home or Heights?
  • Do you want us to forward business mail from other businesses that comes to you at Bethany Lutheran Home or Heights? To whom?
  • Assets

  • Cash on hand or in banks....$
  • Government Securities........$
  • Stocks and Bonds........$
  • Real Estate (approx.)........$
  • Automobiles.........$
  • Other investments..........$
  • Cash Value of Life Insurance ..........$
  • Other Assets - Itemize............$
  • Total Assets....................$
  • Liabilities

  • Unpaid taxes....................$
  • Outstanding loans....................$
  • Unpaid Interests.....................$
  • Other debts - Itemize...$
  • Total Liabilities........ $
  • Income

  • Social Security........ $
  • Pensions........ $
  • Dividends........ $
  • Other Income - Itemized...$
  • Total Income.............$
  • For the purpose of showing financial responsibility, I furnish the foregoing as a true and accurate statement of my financial condition. It is agreed that, if necessary, any of the assets listed will be converted to cash and usedfor the payment and benefit of the person named herein. I also understand that while a resident of Bethany Lutheran Home/Bethany Heights,no transfer of assets shall be made to jeopardize my ability to pay schedule monthly charges. I further understand that any such transfer may be grounds for discharge from Bethany.

    Release of Information I hereby give Bethany Lutheran Home / Heights permission to release my medical information to the Iowa Foundation for Medical Care for the purpose of completing required the pre-admission screening.

  • Signature of applicant/ responsible party
  • Date
Bethany Lutheran Health Services
Bethany Heights
11 Elliott Street Council Bluffs, IA 51503
712-328-8228 info@blhs.care
Bethany Lutheran Home
7 Elliott Street Council Bluffs, IA 51503
712-328-9500 info@blhs.care