Accura Healthcare of Shenandoah: RN Coverage Gaps - IA
The dates, confirmed by the facility's own administrator during a September inspection, were April 20, April 26, May 11, May 18, May 31, and June 21, 2025. On each of those days, federal payroll records show zero registered nurse hours logged.
The administrator told inspectors the facility had only one RN on staff during the entire three-month period. She said her expectation was for eight hours of RN coverage every day. The records showed something different.
Inspectors pulled the Payroll Based Journal data, a federal staffing database nursing homes are required to keep current, and the gaps were plain. Six days. No RN. No hours at all.
The facility's own internal assessment, completed in July 2024, laid out the federal staffing minimums and noted that facilities with higher resident needs may have to staff above those floors. Whether Accura's 40 residents had higher needs, the inspection report does not say. What it says is that on six days across a single quarter, none of them had access to a registered nurse.
The violation was cited at the lowest level of harm. Federal inspectors characterized it as minimal harm or potential for actual harm, a designation that reflects the absence of a documented injury, not the absence of risk. A nursing home with a single RN, no backup, and six days of complete coverage failure is not a facility with a staffing plan that works.
The administrator did not dispute the findings.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Accura Healthcare of Shenandoah from 2025-09-18 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 23, 2026 · Our methodology
Accura Healthcare of Shenandoah in Shenandoah, IA was cited for violations during a health inspection on September 18, 2025.
The dates, confirmed by the facility's own administrator during a September inspection, were April 20, April 26, May 11, May 18, May 31, and June 21, 2025.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.