Entity Details

Basic

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

Medicaid #:
0800235

CCN #:
165424

Occupancy Type:
Beds

Max Occupancy:
126

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
850220

Initial License Date:
10/08/1971

Current License Date:
10/06/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/06/2025

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
04/02/2024

Loss of NA Training Expires:
04/01/2026

Contact

Address:
212 Lafayette Avenue

City:
Story City

State:
Iowa

Zip:
50248-1451

Phone:
(515) 203-7626

Fax:
(515) 733-5293

URL:

Administrator/License #:
Morgan Voga / 123259

Administrator Email:
morgan.voga@bethanylife.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: