Entity Details

Basic

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

Former Entity Name:
Shady Rest Care Center

Medicaid #:
0803627

CCN #:
165568

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
310255

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:
11

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
701 Johnson Street NW

City:
Cascade

State:
Iowa

Zip:
52033-0130

Phone:
(563) 852-3277

Fax:
(515) 686-6049

URL:

Administrator/License #:
Rachel Feeney / 099340

Administrator Email:
shady@netins.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: