1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Royal Oaks Nursing and Rehabilitation Center is a 115-bed skilled nursing facility at 4614 NW 84th Street in Urbandale, Iowa. Owned by Cedar View Holdings LLC and administered by Gianni Beer, the center provides short-term rehabilitation, long-term care, and respite stays for Polk County residents. The campus is somewhat walkable with a Walk Score of 43 and maintains a daily census of approximately 85 residents.
Operational Records and ComplianceThe facility is regulated by the Iowa Department of Inspections, Appeals, and Licensing (DIAL). CMS data as of early 2026 assigns Royal Oaks a 1-star overall rating, categorized as “Much Below Average”. While the quality measure rating is “Average,” the health inspection rating is 1 star, reflecting 59 total citations over recent years, a rate nearly triple the Iowa average. Federal fines totaling $51,555 have been imposed since 2023, and the facility has faced one payment suspension.
Staffing metrics show a focus on therapy, with physical therapist hours at 4 minutes per resident day, 100% above the state average. However, Registered Nurse (RN) hours are 39% below the Iowa average, and weekend RN coverage is 33% below the state mean. Clinical outcomes show zero short-stay falls with major injury, and rehospitalization rates are 48% better than the state average. Conversely, the long-stay hospitalization rate is 57% higher than the Iowa average, and nursing staff turnover is 61.9%.
The campus provides customized care plans within a 24/7 clinical setting. Resident services include housekeeping, laundry, and chef-prepared meals with dietary oversight. The social calendar features pet visits and personalized activities, and residents are permitted to furnish their own living spaces. However, recent state surveys identified multiple environmental and care deficiencies, including failures in behavioral health services and the absence of an effective pest control program.
Families should evaluate the facility’s recent corrective actions during an on-site visit. It is advisable to ask the administrator for specific details on the October 2025 staffing and safety citations and to confirm that the infection control and pest management protocols mentioned in 2024 and 2025 reports have been fully addressed.
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 207th out of 249 homes in Iowa for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | 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.
| 16m per day | ▼ 64% 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.
| 44m per day | ▲ 29% 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.
| 2h 21m per day | ▼ 7% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
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 0m per day | ▼ 10% 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.
| 5m per day | ▲ 136% State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
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.
| 10m per day | ▼ 68% State avg: 30m per day · National avg: 28m per day |
Offers a balance of services and community atmosphere.
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
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Number of hospitalizations per 1,000 long-stay resident days.
2.33
57% worse than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.97
54% 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.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
11.1%
48% better than Iowa averageIowa average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
11.2%
15% better than Iowa averageIowa average: 13.1%
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.
55.2%
In line with Iowa averageIowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
56.4%
12% better than Iowa averageIowa average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
86% of new residents, usually for short-term rehab.
8% of new residents, often for short stays.
6% of new residents, often for long-term daily care.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #71 / 251Payroll — State benchmarkedThis home is ranked 71st out of 251 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.Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #232 / 251Payroll % — State benchmarkedThis home is ranked 232nd out of 251 homes in Iowa. Shows payroll as a percentage of revenue versus the Iowa average. Well-run Iowa facilities typically land around 61–69% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (86% of admissions), and a typical Medicare stay runs around 22 days.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Urbandale's city center to Royal Oaks Nursing and Rehabilitation Center's address, calculated via Google Maps.
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The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
| Karen Acres Health Care Center | NH HC RC | Urbandale (Elm Drive) | 35
Facility
35
IA AVG
71
Rank
#371 / 407 |
88.6%
Facility
88.6%
IA AVG
75.4%
Rank
#73 / 407 | +17% | 3.41
Facility
3.41
IA AVG
4.30
Rank
#226 / 249 | -1% | -21% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 255 | 9
Facility
9
IA AVG
21.7
Rank
#62 / 250 | 2.3
Facility
2.3
IA AVG
4.1
Rank
#47 / 250 | - | 31 | - |
71
Facility
71
IA AVG
45
Rank
#94 / 528 | Pamela Harned | $3.1M
Facility
$3.1M
IA AVG
$7.0M
Rank
#224 / 251 | $1.8M
Facility
$1.8M
IA AVG
$3.1M
Rank
#233 / 251 | 57.2%
Facility
57.2%
IA AVG
46.3%
Rank
#143 / 251 | 165460 | ||||
| Urbandale Health Care Center | NH AL HC RC | Urbandale (84Th Street) | 115
Facility
115
IA AVG
71
Rank
#47 / 407 |
73.0%
Facility
73.0%
IA AVG
75.4%
Rank
#171 / 407 | -3% | 3.58
Facility
3.58
IA AVG
4.30
Rank
#207 / 249 | -7% | -17% | $122.9k
Facility
$122.9k
IA AVG
$53.4k
Rank
#237 / 255 | 59
Facility
59
IA AVG
21.7
Rank
#230 / 250 | 5.9
Facility
5.9
IA AVG
4.1
Rank
#203 / 250 | 6 | 86 | - |
61
Facility
61
IA AVG
45
Rank
#145 / 528 | Jennifer Reiter | $10.7M
Facility
$10.7M
IA AVG
$7.0M
Rank
#37 / 251 | $5.0M
Facility
$5.0M
IA AVG
$3.1M
Rank
#71 / 251 | 47.1%
Facility
47.1%
IA AVG
46.3%
Rank
#232 / 251 | 165580 |
Royal Oaks Nursing and Rehabilitation Center is located in Urbandale, Iowa.
Here are the financial assistance programs available to residents in Iowa.
Royal Oaks Nursing and Rehabilitation Center has a walk score of 43. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
Royal Oaks Nursing and Rehabilitation Center's occupancy is 71.5%.
Yes — there are 9 photos of Royal Oaks Nursing and Rehabilitation Center in the photo gallery on this page.
Royal Oaks Nursing and Rehabilitation Center is located at 4614 Nw 84Th Street, Urbandale, Ia 503221089.
(515) 270-6838 will put you in contact with the team at Royal Oaks Nursing and Rehabilitation Center.
Royal Oaks Nursing and Rehabilitation Center is not currently listed as a CMS-certified provider of Medicare or Medicaid.
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