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.
Staffing hours
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.
Hours per resident per day vs Iowa averages
Total nursing care
This home is ranked 195th out of 234 homes we track 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.
3h 35m
17% below state avg
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.
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.
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.
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.
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.
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.
4 of 6 metrics below state avg
Offers a balance of services and community atmosphere.
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
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 #48 / 224Payroll costs — State benchmarkedThis home is ranked 48th out of 224 homes we track in Iowa. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Iowa average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Iowa that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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 #202 / 224Payroll % of net patient revenue — State benchmarkedThis home is ranked 202nd out of 224 homes we track in Iowa. Shows payroll as a percentage of net patient revenue versus the Iowa average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Iowa that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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.
Add your location
Info below is compiled from CMS reports & the IA Dept. of Inspections, Appeals & Licensing (DIAL), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
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Care Types in This Table
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
PC (Palliative Care):
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Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
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Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
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Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
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This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
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CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
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CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
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CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
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CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
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Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
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Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
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Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
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Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
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Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
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Citations at CMS scope/severity level D or higher — meaning actual harm occurred or residents were placed in immediate jeopardy. Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
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Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
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Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
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Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
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The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
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What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Iowa average is: 60.3% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Karen Acres Health Care Center | NH HOS RC SNF | Urbandale | 35
Facility
35
IA AVG
72
Rank
#369 / 404 |
88.6%
Facility
88.6%
IA AVG
64.7
Rank
#67 / 377 | +37% | 3.41
Facility
3.41
IA AVG
4.30
Rank
#214 / 234 | -1% | -21% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 239 | 9
Facility
9
IA AVG
21.7
Rank
#56 / 232 | 2.3
Facility
2.3
IA AVG
4.1
Rank
#41 / 232 | - | 31 | - |
71
Facility
71
IA AVG
47
Rank
#94 / 505 | Pamela Harned | $3.1MFiscal year ending 12/2023
Facility
$3.1MFiscal year ending 12/2023
IA AVG
$6.9M
Rank
#204 / 224 | $1.8MFiscal year ending 12/2023
Facility
$1.8MFiscal year ending 12/2023
IA AVG
$4.2M
Rank
#211 / 224 | 57.2%Fiscal year ending 12/2023
Facility
57.2%Fiscal year ending 12/2023
IA AVG
60.3%
Rank
#122 / 224 | 165460 | ||||
| Urbandale Health Care Center | NH HOS PC RC SNF | Urbandale | 115
Facility
115
IA AVG
72
Rank
#47 / 404 |
73.0%
Facility
73.0%
IA AVG
64.7
Rank
#173 / 377 | +13% | 3.58
Facility
3.58
IA AVG
4.30
Rank
#195 / 234 | -7% | -17% | $122.9k
Facility
$122.9k
IA AVG
$53.4k
Rank
#222 / 239 | 59
Facility
59
IA AVG
21.7
Rank
#213 / 232 | 5.9
Facility
5.9
IA AVG
4.1
Rank
#186 / 232 | 6 | 84 | - |
61
Facility
61
IA AVG
47
Rank
#145 / 505 | Jennifer Reiter | $10.7MFiscal year ending 12/2023
Facility
$10.7MFiscal year ending 12/2023
IA AVG
$6.9M
Rank
#27 / 224 | $5.0MFiscal year ending 12/2023
Facility
$5.0MFiscal year ending 12/2023
IA AVG
$4.2M
Rank
#48 / 224 | 47.1%Fiscal year ending 12/2023
Facility
47.1%Fiscal year ending 12/2023
IA AVG
60.3%
Rank
#202 / 224 | 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%.
No, Royal Oaks Nursing and Rehabilitation Center has a no-pet policy.
Royal Oaks Nursing and Rehabilitation Center is registered as a for-profit.
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 50322-1089.
(515) 270-6838 will put you in contact with the team at Royal Oaks Nursing and Rehabilitation Center.
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