Entity Details

Basic

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

Medicaid #:
0802470

CCN #:
165437

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
330221

Initial License Date:
04/01/1976

Current License Date:
04/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2025

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:
100 Bolger Drive

City:
Fayette

State:
Iowa

Zip:
52142-9762

Phone:
(563) 425-3336

Fax:
(563) 425-3512

URL:

Administrator/License #:
Betty Hildebrand / 111587

Administrator Email:
mcmadministrator@maplecrestmanor.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: