Entity Details

Basic

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

Medicaid #:
0800169

CCN #:
165442

Occupancy Type:
Beds

Max Occupancy:
100

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
090286

Initial License Date:

Current License Date:
02/14/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/13/2025

Months Since Last Survey:
9

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1922 Fifth Avenue NW

City:
Waverly

State:
Iowa

Zip:
50677-1903

Phone:
(319) 352-4540

Fax:
(319) 352-2161

URL:

Administrator/License #:
Veronica Shea / 090092

Administrator Email:
vshea@bartelscommunity.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: