Entity Details

Basic

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

Medicaid #:
0803247

CCN #:
165413

Occupancy Type:
Beds

Max Occupancy:
41

Status:
Closed

Close Date:
02/17/2023

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
110376

Initial License Date:

Current License Date:
10/14/2022

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/14/2023

Months Since Last Survey:
16

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
410 Spruce Street

City:
Albert City

State:
Iowa

Zip:
50510-1310

Phone:
(712) 843-2238

Fax:
(712) 843-2233

URL:

Provisional Administrator:
Mavis Loving

Provisional Administrator Email:
admin@pvhalbertcity.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: