Page County, Iowa · Nursing home
Accura Healthcare of Shenandoah
1 of 5 overall from CMS
1203 South Elm Street, Shenandoah, IA 51601
At a glance
- Overall rating 1 of 5 Below the state average of 3.1
- Nurse time per resident, per day 3.63 hours Below the state average of 3.82
- Nursing staff who left in a year 60.4% Above the state average of 44.0%
- Health citations, last 3 inspection cycles 32 3 at the harm level or above
- Fines in 3 years $8,414 1 fine
- Certified beds in use 97.9% of 42 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Accura Healthcare of Shenandoah is a 42-bed nursing home in Shenandoah, Iowa (Page County). CMS rates it 1 of 5 stars overall as of Sep 2026. It reports 3.63 nurse staffing hours per resident per day, below the Iowa average of 3.82. CMS lists 1 fine totaling $8,414 in the past three years.
- Certified beds
- 42
- Residents per day (average)
- 41.1
- Certified since
- 2004 (22 yrs)
For profit - Limited Liability company Participates in Medicare and MedicaidPart of Accura Healthcare (41 homes)
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Accura Healthcare of Shenandoah
Chosen from this home's public data.
- CMS lists 1 fine totaling $8,414 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 11 health deficiencies in the latest inspection cycle (the standard inspection on Sep 18, 2025 plus complaint and infection-control inspections); the Iowa average is 6.5. Which have been corrected?Inspection results in CMS data
- Nursing staff turnover is 60.4%, above the Iowa average of 44.0%. How often would the same aides care for my relative?Turnover in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 1 of 5 Iowa average 3.1
- Health inspections 1 of 5 Iowa average 2.8
- Staffing 1 of 5 Iowa average 3.7
- Quality measures 1 of 5 Iowa average 3.3
The vertical line marks the Iowa average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 3.63 h Iowa average 3.82
- Nurse aides 2.49 h Iowa average 2.52
- Licensed practical nurses 0.54 h Iowa average 0.56
- Registered nurses 0.60 h Iowa average 0.74
- All staff, weekends 3.21 h Iowa average 3.37
How much nurse staffing is enough? All bars share one scale, 0 to 11 hours. The vertical line marks the Iowa average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover60.4%
- Iowa average44.0%
- Registered nurse turnover50.0%
- Iowa average42.1%
- Administrators who left0
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Iowa and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | Iowa | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 17.4% | 17.1% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 3.4% | 4.6% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.1% | 1.5% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 15.5% | 2.4% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 5.3% | 4.2% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.2% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 8.4% | 3.8% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.6% | 94.0% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 18.6% | 16.6% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 19.7% | 20.8% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 97.5% | 95.3% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 1.9% | 4.2% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 29.7% | 25.6% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 12.9% | 19.5% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 3.81 | 1.49 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 7.98 | 2.08 | 1.78 |
Short-stay residents
| Measure | This home | Iowa | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 98.7% | 84.0% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 7.3% | 2.1% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Too few residents or stays to report | 73.3% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 35.7% | 20.9% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 24.0% | 13.2% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 32 health deficiencies in the three most recent inspection cycles. Of these, 2 were at the immediate jeopardy level and 1 involved actual harm; the rest were graded as no actual harm. 5 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Dec 6, 2023: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Sep 18, 2025 | 11 | 5 |
| Oct 17, 2024 | 8 | 6 |
| Jun 29, 2023 | 13 | 6 |
Iowa homes averaged 6.5 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (32)
-
EPotential for more than minimal harm, pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services · Deficient, Provider has date of correction (Oct 10, 2025)
-
EPotential for more than minimal harm, pattern
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Oct 10, 2025)
-
EPotential for more than minimal harm, pattern
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary · Deficient, Provider has date of correction (Oct 10, 2025)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Oct 10, 2025)
-
EPotential for more than minimal harm, pattern
Have a plan that describes the process for conducting QAPI and QAA activities.
Administration · Deficient, Provider has date of correction (Oct 10, 2025)
Show 25 more
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights · Deficient, Provider has date of correction (Oct 10, 2025)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights · Deficient, Provider has date of correction (Oct 10, 2025)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Oct 10, 2025)
-
DPotential for more than minimal harm, isolated
PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Oct 10, 2025)
-
DPotential for more than minimal harm, isolated
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care · Deficient, Provider has date of correction (Oct 10, 2025)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Oct 10, 2025)
-
EPotential for more than minimal harm, pattern
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Nov 7, 2024)
-
EPotential for more than minimal harm, pattern
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Nursing and Physician Services · Deficient, Provider has date of correction (Nov 7, 2024)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Nov 7, 2024)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Nov 7, 2024)
-
DPotential for more than minimal harm, isolated
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights · Deficient, Provider has date of correction (Nov 7, 2024)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Nov 7, 2024)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Nov 7, 2024)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Sep 19, 2024)
-
KImmediate jeopardy, pattern
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 7, 2023)
-
JImmediate jeopardy, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 7, 2023)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Dec 7, 2023)
-
GActual harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Observe each nurse aide's job performance and give regular training.
Nursing and Physician Services · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Dispose of garbage and refuse properly.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 18, 2023)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Jul 18, 2023)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights · Deficient, Provider has date of correction (Jul 18, 2023)
Showing the 30 most recent of 32.
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Dec 6, 2023 | Fine | $8,414 |
Iowa homes averaged 0.6 fines and $19,286 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within Iowa
- Size318 of 387 by certified beds
- Iowa average residents per day52.4
- ChainAccura Healthcare
- Chain average overall rating2.5 of 5
- Resident or family councilResident
- Homes in Page County3
Common questions
What is the CMS star rating for Accura Healthcare of Shenandoah?
Accura Healthcare of Shenandoah has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 1, staffing is 1 and quality measures is 1.
How many beds does Accura Healthcare of Shenandoah have?
Accura Healthcare of Shenandoah has 42 certified beds. It averages 41.1 residents per day, about 97.9% of its certified beds.
How much nursing care do residents get at Accura Healthcare of Shenandoah?
The home reports 3.63 hours of nurse staffing per resident per day, including 0.60 hours from registered nurses. The Iowa average is 3.82 hours and 0.74 hours from registered nurses.
Has Accura Healthcare of Shenandoah been fined?
Yes. CMS lists 1 fine totaling $8,414 in the past three years.
Does Accura Healthcare of Shenandoah accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- – not rated Garden View Care Center 50beds 65.2%in use 4.33nurse hours a day
- 4 of 5 The Ambassador Sidney Inc 46beds 88.7%in use 3.54nurse hours a day
- 2 of 5 Azria Health Clarinda 70beds 84.6%in use 3.66nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Page County
Who to call in Iowa
These offices serve residents of every nursing home in Iowa.
- Long-term care ombudsman Office of the State Long-Term Care Ombudsman 866-236-1430 (Toll-free. Relay Iowa TTY: 1-800-735-2942. The page also offers an online complaint form.) An advocate for residents and their families.
- File a complaint about a nursing home Health Facilities Complaints Hotline 1-877-686-0027 (Email hfd_complaint@dia.iowa.gov; complaints fax 515-281-7106. DIAL's complaints page links to an online complaint form (stateofiowa.seamlessdocs.com/f/DIA_Contact_Form).) The state agency that inspects nursing homes.
Iowa staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 165529. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.