43.2/100
Below average
1203 South Elm Street, Shenandoah, IA 51601
These are findings in the public CMS record for this home. They are not our opinion — each one comes straight from a federal inspection or enforcement file.
3 citation(s) involving actual harm or immediate jeopardy
Inspectors found violations at scope/severity G or above, meaning residents were harmed or placed in immediate jeopardy.
$8,414 in federal fines
CMS has fined this facility across 1 penalty action(s).
Nursing staff turnover of 60%
High turnover means residents rarely see the same caregiver twice. The national average is about 50%.
Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.
Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.
How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.
The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.
Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.
Grade ceiling applied
Hours of nursing care each resident receives per day. The marker on each bar is the national average.
RNs are the licence level most likely to catch a resident deteriorating.
The shift most families visit, and the one thinned first.
The share of nursing staff who left over the last year.
Last standard health inspection: September 18, 2025 (11 months ago).
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
No actual harm, potential for more than minimal harm
Nursing and Physician Services Deficiencies
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.
No actual harm, potential for more than minimal harm
Nutrition and Dietary Deficiencies
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.
No actual harm, potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
No actual harm, potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
No actual harm, potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
No actual harm, potential for more than minimal harm
Resident Rights Deficiencies
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.
No actual harm, potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
No actual harm, potential for more than minimal harm
Part of ACCURA HEALTHCARE, which operates 43 homes. Staffing budgets are usually set at chain level, not in the building.
| Owner | Type | Role | Since |
|---|---|---|---|
| HUMMEL, ASHLEY | Individual | W-2 MANAGING EMPLOYEE | — |
| SMITH, TIMOTHY | Individual | W-2 MANAGING EMPLOYEE | — |
| TOTI, LISA | Individual | W-2 MANAGING EMPLOYEE | — |
| LENEAVE, TED | Individual | CORPORATE DIRECTOR | — |
| LENEAVE, THOMAS | Individual | CORPORATE DIRECTOR | — |
| TOTI, LISA | Individual | CORPORATE DIRECTOR | — |
| LENEAVE, TED | Individual | CORPORATE OFFICER | — |
| LENEAVE, THOMAS | Individual | CORPORATE OFFICER | — |
| AMERICAN HEALTHCARE MANAGEMENT SERVICES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — |
| LENEAVE, THOMAS | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — |
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Accura Healthcare Of Shenandoah holds an ElderGrade of D (43.2 out of 100), which we describe as "below average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.
Residents receive an average of 3.63 nursing hours per day across all nursing staff, against a national average of 3.86 hours.
Yes. 3 of the 32 citations on record were scored at scope and severity G or above, meaning inspectors found actual harm to a resident or immediate jeopardy to resident safety.
Yes, Accura Healthcare Of Shenandoah is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.