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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 195th out of 224 homes in Iowa.| Staff type | Hours / day | vs state avg |
|---|---|---|
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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.
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27m per day | ▼ 39% State avg: 44m per day · National avg: 41m per day |
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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.
|
43m per day | ▲ 26% State avg: 34m per day · National avg: 52m per day |
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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.
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2h 12m per day | ▼ 13% State avg: 2h 32m per day · National avg: 2h 20m per day |
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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.
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2h 58m per day | ▼ 11% 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.
|
4m per day | ▲ 100% 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.
|
20m per day | ▼ 33% State avg: 30m per day · National avg: 28m per day |
Occupancy lower than 85% suggests more openings may be available.
Most residents typically stay for a few weeks or months before returning home or moving on.
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.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #50 / 226Payroll — state benchmarkedThis home is ranked 50th 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.
Iowa average 4.9
Last Health inspection on Oct 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.
22 of 59 citations resulted from standard inspections; 29 of 59 resulted from complaint investigations; and 8 of 59 came from combined inspections (standard and complaint).
233% worse than Iowa average
Iowa average: 0.6
4
344% worse than Iowa average
Iowa average: 0.9
Issues related to the availability and quality of nursing staff and the care they provide.
Oct 22, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Oct 22, 2025
Corrected
Issues related to creating and updating personalized care plans for residents based on their needs and conditions.
Oct 22, 2025
Corrected
Issues related to preventing and controlling infections, including hygiene practices and safety protocols.
May 20, 2025
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.
Royal Oaks Nursing and Rehabilitation Center is located in Urbandale, Iowa.
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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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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
48% worse than Iowa average
Iowa average ratio: 2.00:1
15% better than Iowa average
Iowa 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.
9.5 hours
No 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.
10 hours
This role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.6 hours
No contractors work on this role.
Total hours from contractors
789 contractor hours this quarter
| Certified Nursing Assistant | 37 | 0 | 37 | 13,896 | 91 | 100% | 8.6 |
| Licensed Practical Nurse | 14 | 1 | 15 | 4,627 | 91 | 100% | 10 |
| Medication Aide/Technician | 8 | 0 | 8 | 2,998 | 91 | 100% | 9.2 |
| Registered Nurse | 6 | 0 | 6 | 2,201 | 91 | 100% | 9.5 |
| RN Director of Nursing | 3 | 0 | 3 | 1,375 | 71 | 78% | 9.5 |
| Other Dietary Services Staff | 3 | 0 | 3 | 1,155 | 80 | 88% | 6.7 |
| Speech Language Pathologist | 3 | 0 | 3 | 922 | 65 | 71% | 7.3 |
| Respiratory Therapy Technician | 2 | 0 | 2 | 621 | 68 | 75% | 6.1 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 555 | 62 | 68% | 7.9 |
| Administrator | 1 | 0 | 1 | 480 | 64 | 70% | 7.5 |
| Nurse Practitioner | 1 | 0 | 1 | 473 | 63 | 69% | 7.5 |
| Qualified Social Worker | 2 | 0 | 2 | 268 | 54 | 59% | 5 |
| Physical Therapy Assistant | 2 | 0 | 2 | 231 | 57 | 63% | 3.6 |
| Occupational Therapy Aide | 0 | 1 | 1 | 130 | 14 | 15% | 9.3 |
| Physical Therapy Aide | 1 | 0 | 1 | 53 | 20 | 22% | 2.6 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 51 | 9 | 10% | 5.7 |
| Medical Director | 0 | 1 | 1 | 2 | 2 | 2% | 1 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
85
Residents meet regularly to discuss policies, care quality, and activities
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.
8.7
15% better than Iowa average
Iowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
18.4
15% better than Iowa average
Iowa 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
13.8%
27% better than Iowa average
Iowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
15.0%
24% better than Iowa average
Iowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
26.5%
In line with Iowa average
Iowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
1.7%
54% better than Iowa average
Iowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
6.4%
46% worse than Iowa average
Iowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
1.0%
58% better than Iowa average
Iowa average: 2.5%
Percent of long-stay residents who lose too much weight
6.5%
31% worse than Iowa average
Iowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
4.6%
18% worse than Iowa average
Iowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
17.5%
8% better than Iowa average
Iowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
95.7%
In line with Iowa average
Iowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
86.8%
9% worse than Iowa average
Iowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
2.33
57% worse than Iowa average
Iowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.97
54% better than Iowa average
Iowa 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
82.5%
In line with Iowa average
Iowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
0.7%
63% better than Iowa average
Iowa average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
60.3%
18% worse than Iowa average
Iowa average: 73.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
11.1%
48% better than Iowa average
Iowa average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
11.2%
15% better than Iowa average
Iowa average: 13.1%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Iowa average
Iowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
55.2%
In line with Iowa average
Iowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
56.4%
12% better than Iowa average
Iowa 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 (Data as of Jan 2026)
154% higher than Iowa average
Iowa average: $48K
77% more fines than Iowa average
Iowa average: 1.7
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
2
276% more payment denials than Iowa average
Iowa average: 0.5
Penalties are imposed by CMS for violations of federal nursing home regulations.
5 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 22, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Dec 12, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Dec 6, 2023
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Dec 6, 2023
Last updated: Jan 2026
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| Karen Acres Health 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.
HC
Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
N
Nursing
RC
Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. |
Urbandale (Elm Drive) | 35 | 85.1% | +13% | 3.41 | +25% | -21% | 0 | 9 | 2.3 | 0 | 30 | - | 71 | Harned, Pamela | $3.8M | $1.6M | 40.9% | 165460 | ||||
| Deerfield Health 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.
IL
Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
N
Nursing |
Urbandale | 30 | 83.7% | +11% | 6.95 | +37% | +62% | 1 | 7 | 1.8 | 1 | 18 | A+ | 5 | Bear, Scott | $7.9M | $2.8M | 35.4% | 165557 | ||||
| Royal Oaks Nursing and Rehabilitation 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. |
Urbandale | 115 | 71.5% | -5% | 3.58 | -42% | -17% | 3 | 59 | 5.9 | 6 | 85 | - | - | Reiter, Jennifer | $13.3M | $4.4M | 33% | 165580 | ||||
| Urbandale Health 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.
HC
Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
N
Nursing
RC
Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. |
Urbandale (84Th Street) | 115 | 71.5% | -5% | 3.58 | -42% | -17% | 3 | 59 | 5.9 | 6 | 85 | - | 61 | Reiter, Jennifer | $13.3M | $4.4M | 33% | 165580 |
Historical financial and operational data for Royal Oaks Nursing and Rehabilitation Center based on CMS SNF Cost Reports.
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