Entity Details

Basic

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

Medicaid #:
0806414

CCN #:
165515

Occupancy Type:
Beds

Max Occupancy:
50

Status:
Closed

Close Date:
09/13/2022

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
860976

Initial License Date:

Current License Date:
02/02/2022

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/02/2023

Months Since Last Survey:
34

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
401 Crisman Street

City:
Dysart

State:
Iowa

Zip:
52224-0249

Phone:
(319) 476-2400

Fax:
(319) 476-3622

URL:

Provisional Administrator:
Ashley Kersten

Provisional Administrator Email:
akersten@qhcmcares.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: