Nursing Care Index

Accura Healthcare Of Shenandoah

Shenandoah, Page County, Iowa · CCN 165529 · For-profit (LLC) · part of Accura Healthcare (41 facilities, chain average 2.5 stars)

CMS rates Accura Healthcare Of Shenandoah 1 of 5 overall as of August 2026. 42 certified beds, 41 residents a day on average. 32 citations on record from the current inspection cycles, 2 at immediate jeopardy; 1 fine totalling $8,414.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★☆☆☆☆ 1 of 5
Quality measures★☆☆☆☆ 1 of 5
Quality: long-stay / short-stay2 / 1 of 5

Staffing

Total nurse staffing3.63088 hours per resident per day
Registered nurses0.59924 hours per resident per day
Weekend total3.20624 hours per resident per day
Nursing staff turnover60.4% (registered nurses 50%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2025-09-18 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 Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-10
2025-09-18
complaint survey
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 Deficiencies · tag F0727
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-10
2025-09-18 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 Deficiencies · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-10
2025-09-18 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-10
2025-09-18 Have a plan that describes the process for conducting QAPI and QAA activities.
Administration Deficiencies · tag F0865
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-10-10
2025-09-18 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2025-09-18 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 Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2025-09-18 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2025-09-18 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2025-09-18 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2025-09-18 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-10
2024-10-17 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 Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-07
2024-10-17 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 Deficiencies · tag F0727
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-07
2024-10-17 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-07
2024-10-17 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-07
2024-10-17 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-07
2024-10-17 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-07
2024-10-17 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-07
2024-09-15
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-19
2023-12-06
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2023-12-07
2023-12-06
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-12-07
2023-12-06
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-12-07
2023-06-29 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2023-07-18
2023-06-29 Observe each nurse aide's job performance and give regular training.
Nursing and Physician Services Deficiencies · tag F0730
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 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 Deficiencies · tag F0801
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 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 Deficiencies · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 Dispose of garbage and refuse properly.
Nutrition and Dietary Deficiencies · tag F0814
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-18
2023-06-29 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 Deficiencies · tag F0585
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-18
2023-06-29 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-18
2023-06-29 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-18

Fines and payment denials

DatePenaltyAmount
2023-12-06Fine$8,414

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
American Healthcare Management Services LLC
Organization
operational/managerial control2020-08-01
Leneave, Thomas
Individual
5% or greater indirect ownership interest30%2020-08-01
Leneave, Ted
Individual
corporate director2020-08-01
Leneave, Thomas
Individual
corporate director2020-08-01
Toti, Lisa
Individual
corporate director2021-01-01
Leneave, Ted
Individual
corporate officer2020-08-01
Leneave, Thomas
Individual
corporate officer2020-08-01
Hummel, Ashley
Individual
w-2 managing employee2024-01-01
Smith, Timothy
Individual
w-2 managing employee2024-04-01
Toti, Lisa
Individual
w-2 managing employee2021-01-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Page County.