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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 25th out of 224 homes in Iowa.| Staff type | Hours / day | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 23m per day | ▼ 48% State avg: 44m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 37m per day | ▲ 9% State avg: 34m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 3h 19m per day | ▲ 31% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Total Nursing (Weekend)
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 49m per day | ▲ 14% State avg: 3h 21m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 3m per day | ▲ 50% State avg: 2m per day · National avg: 4m per day |
|
RN (Weekend)
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 17m per day | ▼ 43% State avg: 30m per day · National avg: 28m per day |
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
30% of new residents, usually for short-term rehab.
36% of new residents, often for short stays.
34% of new residents, often for long-term daily care.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #101 / 226Payroll — state benchmarkedThis home is ranked 101st out of 226 homes in Iowa.Shows total annual staff payroll benchmarked to the Iowa average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Lower than the Iowa average: 75.4%Keystone Nursing Care Center is administrated by Tracy Bruns.
In Iowa, the Department of Inspections, Appeals, and Licensing conducts unannounced health and safety surveys to monitor compliance and protect residents in long-term care settings.
Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.
Iowa average: 17 visits/inspections
Iowa average: 0 inspections
Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.
Iowa average: 27 deficiencies
The most recent inspection on September 11, 2025 found the facility to be in substantial compliance with no deficiencies cited. Earlier inspections showed a mixed record, with some deficiencies related mainly to resident care issues such as failure to follow care plans during transfers, medication documentation, and food labeling. A substantiated complaint in February 2025 involved a resident fall due to improper use of a mechanical lift, resulting in injury, and prior complaints related to care and documentation were also substantiated. Enforcement actions such as fines or license suspensions were not listed in the available reports. The facility appears to have addressed prior deficiencies effectively, with the most recent inspections showing compliance and correction of earlier issues.
Iowa average 4.9
Last Health inspection on Feb 2025
Iowa average 21.7
Iowa average 4.11
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
1 of 3 citations resulted from standard inspections; 1 of 3 resulted from complaint investigations; and 1 of 3 came from combined inspections (standard and complaint).
100% better than Iowa averageIowa average: 0.6
1
11% worse than Iowa averageIowa average: 0.9
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Feb 06, 2025
Corrected
Issues related to medication management, including how drugs are stored, administered, and monitored.
Jun 22, 2023
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Jun 22, 2023
Corrected
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Keystone Nursing Care Center is located in Keystone, Iowa.
Here are the financial assistance programs available to residents in Iowa.
0.0 miles from city center
Estimated distance in miles from Keystone's city center to Keystone Nursing Care Center's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
8% better than Iowa averageIowa average ratio: 2.00:1
5% worse than Iowa averageIowa average: 7.4 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8 hoursNo contractors work on this role.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hoursNo contractors work on this role.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.5 hoursThis role is partially covered by contractors.
Total hours from contractors
493 contractor hours this quarter
| Certified Nursing Assistant | 40 | 2 | 42 | 9,866 | 91 | 100% | 7.5 |
| Licensed Practical Nurse | 8 | 0 | 8 | 2,300 | 91 | 100% | 7.8 |
| Medication Aide/Technician | 9 | 0 | 9 | 2,210 | 90 | 99% | 7.6 |
| Registered Nurse | 6 | 0 | 6 | 855 | 79 | 87% | 8 |
| Administrator | 2 | 0 | 2 | 773 | 62 | 68% | 6.9 |
| Nurse Practitioner | 3 | 0 | 3 | 477 | 59 | 65% | 8.1 |
| Mental Health Service Worker | 1 | 0 | 1 | 453 | 58 | 64% | 7.8 |
| Dietitian | 1 | 0 | 1 | 446 | 59 | 65% | 7.6 |
| Other Dietary Services Staff | 1 | 0 | 1 | 334 | 49 | 54% | 6.8 |
| Speech Language Pathologist | 0 | 7 | 7 | 179 | 57 | 63% | 2.1 |
| Physical Therapy Assistant | 0 | 4 | 4 | 159 | 54 | 59% | 2.6 |
| Nurse Aide in Training | 1 | 0 | 1 | 140 | 19 | 21% | 7.4 |
| Respiratory Therapy Technician | 0 | 4 | 4 | 82 | 40 | 44% | 1.9 |
| Occupational Therapy Aide | 1 | 0 | 1 | 72 | 12 | 13% | 6 |
| Qualified Social Worker | 0 | 3 | 3 | 25 | 22 | 24% | 1.1 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 20 | 4 | 4% | 5.1 |
| Physical Therapy Aide | 0 | 2 | 2 | 14 | 10 | 11% | 1.4 |
| Other Physician | 0 | 1 | 1 | 2 | 3 | 3% | 0.5 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
45Residents meet regularly to discuss policies, care quality, and activities
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Part of a Continuing Care Retirement Community offering multiple care levels
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
10.3
In line with Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
23.9
11% worse than Iowa averageIowa average: 21.6
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
21.0%
12% worse than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
15.9%
19% better than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
34.9%
33% worse than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
5.2%
43% worse than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
5.1%
16% worse than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
0.7%
74% better than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
4.2%
17% better than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
6.5%
66% better than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
6% better than Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
5% better than Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
0.82
45% better than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.22
42% better than Iowa averageIowa average: 2.09
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
18% better than Iowa averageIowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than Iowa averageIowa average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
87.0%
19% better than Iowa averageIowa average: 73.3%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Iowa averageIowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
57.1%
6% better than Iowa averageIowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
51.0%
In line with Iowa averageIowa average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
Penalties are imposed by CMS for violations of federal nursing home regulations.
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
| Akron Care Center, INC |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Akron | 45 | 98.1% | +30% | 4.71 | +15% | +10% | 0 | 4 | 2.0 | 0 | 42 | - | City Of Akron | $4.7M | $2.1M | 45.1% | 165595 | ||||
| Keystone Nursing Care Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Keystone | 55 | 90.2% | +20% | 5.27 | -46% | +23% | 0 | 3 | 1.5 | 1 | 42 | - | Hanson, Tracy | $6.1M | $3.3M | 53.7% | 165604 | ||||
| Accura HealthCare of Carlisle |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Carlisle | 80 | 80.5% | +7% | 5.85 | -40% | +36% | 0 | 17 | 5.7 | 2 | 39 | - | American Healthcare Associates Inc | $4.1M | $2.5M | 59.6% | 165311 | ||||
| Accura Healthcare of Spirit Lake |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Spirit Lake | 85 | 66.6% | -12% | 4.29 | -8% | 0% | 1 | 21 | 7.0 | 1 | 65 | - | - | $7.1M | $3.0M | 42.3% | 165528 | ||||
| Accura Healthcare of Lake City, LLC |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Lake City | 46 | 70.4% | -7% | 5.17 | -33% | +20% | 4 | 39 | 3.9 | 4 | 40 | - | Accura Healthcare Of The Heartland Llc | $2.1M | $1.0M | 46.7% | 165082 |
Historical financial and operational data for Keystone Nursing Care Center based on CMS SNF Cost Reports.
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