Entity Details

Basic

Entity Type:
Free Standing NF/SNF (Free Standing NF/SNF)

Former Entity Name:
Donnellson Health Center

Medicaid #:
0808378

CCN #:
165260

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
560614

Initial License Date:

Current License Date:
05/14/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/13/2024

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
12/14/2022

Loss of NA Training Expires:
12/13/2024

Contact

Address:
901 State Street

City:
Donnellson

State:
Iowa

Zip:
52625-0250

Phone:
(319) 835-5621

Fax:
(319) 835-5053

URL:

Administrator/License #:
Talisa Jacobs / 092863

Administrator Email:
tjacobs@donnellsonltc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: