Entity Details

Basic

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

Medicaid #:
0801357

CCN #:
165531

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
730056

Initial License Date:
10/05/1971

Current License Date:
02/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/01/2027

Months Since Last Survey:
4

Entity Type Survey Cycle(months):
12

Special Focus Facility:
Yes

Special Focus Facility Survey Cycle(months):
6

Loss of NA Training Effective:
12/08/2025

Loss of NA Training Expires:
12/08/2027

Contact

Address:
1200 West Nishna Road

City:
Shenandoah

State:
Iowa

Zip:
51601-2199

Phone:
(712) 246-4515

Fax:
(712) 246-5085

URL:

Administrator/License #:
JR Moss / 074692

Administrator Email:
jmoss@shenandoahhc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: