Entity Details

Basic

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

Medicaid #:
0802512

CCN #:
165355

Occupancy Type:
Beds

Max Occupancy:
35

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
540351

Initial License Date:

Current License Date:
07/01/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
06/30/2024

Months Since Last Survey:
4

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
204 N Keokuk Washington Road

City:
Keota

State:
Iowa

Zip:
52248-9496

Phone:
(641) 636-3400

Fax:
(641) 636-3150

URL:

Administrator/License #:
Janelle Case / 111362

Administrator Email:
admin@keotahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: