Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Clarksville Skilled Nursing & Rehab Center

Clarksville, IA · 42 certified beds · Last Life Safety survey April 9, 2026

CMS Certification Number 165495 · first certified April 2004

Ownership

Independently operated (no chain recorded by CMS) · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

4
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
1
Inspection & testing records
Of the citations on file

Position within IA

4 citations — more than 9% of the 387 certified nursing homes in IA. Compared within IA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Holding steadyabout the same at the latest survey as at its earlier surveys in the window.

The latest survey found 1 citation; the earlier surveys in the window averaged 1.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens February 2027 — about 5 months from now. This facility’s last Life Safety survey was April 2026. Facilities in IA are typically surveyed 11–13 months after the last one (median 12), measured over 700 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

Emergency preparedness

1 of the 4 citations on file is Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

How that compares

Citations on file over three years

Compared with the median facility in IA, and nationally. Surveyors differ markedly between states, so the IA figure is the meaningful one.

This facility4IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility4
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
22024-0412025-0412026-04
Citations at each Life Safety survey
Survey dateCitations
April 11, 20242
April 3, 20251
April 9, 20261

Most-cited tags

Most-cited tags at this facility
K-03531K-02221E-00261K-01331
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.12025-04-03
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.12024-04-11
E-0026Establish roles under a Waiver declared by secretary.12024-04-11
K-0133Install a two-hour-resistant firewall separation.12026-04-09

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 1
  • Egress Deficiencies 1
  • Emergency Preparedness Deficiencies 1
  • Construction Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies1
Egress Deficiencies1
Emergency Preparedness Deficiencies1
Construction Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

April 9, 2026 — 1 citation

Citations issued on April 9, 2026
TagWhat the surveyor checksStatus
K-0133Install a two-hour-resistant firewall separation.Deficient, Provider has date of correction (April 8, 2026)

April 3, 2025 — 1 citation

Citations issued on April 3, 2025
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 4, 2025)

April 11, 2024 — 2 citations

Citations issued on April 11, 2024
TagWhat the surveyor checksStatus
E-0026Establish roles under a Waiver declared by secretary.Deficient, Provider has date of correction (April 17, 2024)
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (April 19, 2024)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.