Entity Details

Basic

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

Medicaid #:
0803973

CCN #:
165358

Occupancy Type:
Beds

Max Occupancy:
57

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
140430

Initial License Date:

Current License Date:
04/30/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/30/2025

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
217 Main Street

City:
Coon Rapids

State:
Iowa

Zip:
50058-1692

Phone:
(712) 999-2253

Fax:
(712) 999-5669

URL:

Provisional Administrator:
Virginia Murrane

Provisional Administrator Email:
vmurrane@thomasresthaven.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: