Keystone, IA

Keystone Nursing Care Center INC

5-star overall rating with 5-star inspections with 4 fire-safety deficiencies in the latest cycle

250 Fifth Street, Keystone, IA

(319) 442-3234

Compare this facility

Overall

5 / 5

CMS overall stars

Health inspections

5 / 5

Survey and complaint cycles

Staffing

4 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

55

Certified beds

Average residents

40

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

2012-07-17

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.38

Registered nurse staffing · state 0.73 · national 0.68

LPN hours / resident day

0.62

Licensed practical nurse staffing · state 0.57 · national 0.87

Aide hours / resident day

3.32

Nurse aide staffing · state 2.53 · national 2.35

Total nurse hours

4.33

All reported nurse hours · state 3.83 · national 3.89

Licensed hours

1.00

RN + LPN hours · state 1.30 · national 1.54

Weekend hours

3.72

Weekend nurse staffing · state 3.35 · national 3.43

Weekend RN hours

0.28

Weekend registered nurse coverage · state 0.50 · national 0.47

Physical therapist

0.05

Reported PT staffing · state 0.04 · national 0.07

Adjusted RN hours

0.48

CMS adjusted RN staffing hours

Adjusted total hours

5.41

CMS adjusted total nurse staffing hours

Case-mix index

1.09

Higher values indicate more complex resident acuity

RN turnover

0%

Annual RN turnover

Total nurse turnover

54%

Annual nurse turnover · state 44% · national 46%

SNF VBP

Value-based purchasing

Program rank

6,582

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

32.34

Composite VBP score used to determine payment impact.

Payment multiplier

0.9870

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

2.72

Baseline 20.16% · Performance 20.17% · Measure score 2.72 · Achievement 2.72 · Improvement 0

Healthcare-associated infections

0

Baseline 6.63% · Performance 7.79% · Measure score 0 · Achievement 0 · Improvement 0

Total nurse turnover

6.52

Baseline 51.72% · Performance 37.04% · Measure score 6.52 · Achievement 6.52 · Improvement 4.97

Adjusted total nurse staffing

3.70

Baseline 4.13 hours · Performance 4.13 hours · Measure score 3.70 · Achievement 3.70 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	8.89%	10.72% 1.8 pts better	No Different than the National Rate · Eligible stays 49 · Observed rate 0% · Lower 95% interval 5.73%
Discharge to community	50.98%	50.57% 0.4 pts better	No Different than the National Rate · Eligible stays 32 · Observed rate 46.88% · Lower 95% interval 37.73%
Medicare spending per beneficiary	0.89	1.02 0.1 pts better
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 22 · Denominator 22
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 22
Discharge self-care score	57.14%	53.69% 3.5 pts better	Numerator 12 · Denominator 21
Discharge mobility score	66.67%	50.94% 15.7 pts better	Numerator 14 · Denominator 21
Pressure ulcers or injuries, new or worsened	0%	2.29% 2.3 pts better	Numerator 0 · Denominator 22 · Adjusted rate 0%
Healthcare-associated infections requiring hospitalization	7.79%	7.12% 0.7 pts worse	No Different than the National Rate · Eligible stays 35 · Observed rate 8.57% · Lower 95% interval 4.31%
Staff COVID-19 vaccination coverage	2%	8.2% 6.2 pts worse	Numerator 2 · Denominator 100
Staff flu vaccination coverage	52.04%	42% 10 pts better	Numerator 51 · Denominator 98
Discharge function score	76.19%	56.45% 19.7 pts better	Numerator 16 · Denominator 21
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 1 · Too few residents or stays to report publicly.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	0.8	1.5 0.7 pts better	1.9 1.1 pts better	Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.6 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	1.2	2.1 0.9 pts better	1.8 0.6 pts better	Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.1 · Expected 1.6 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	94.0% 6 pts better	93.4% 6.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	100.0%	95.2% 4.8 pts better	95.5% 4.5 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury	3.3%	3.7% 0.4 pts better	3.3% About the same	Long Stay · 2024Q4-2025Q3 · Q1 7.3% · Q2 5.1% · Q3 0.0% · Q4 0.0% · 4Q avg 3.3% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	0.0%	4.0% 4 pts better	11.4% 11.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents who lose too much weight	5.1%	4.9% 0.2 pts worse	5.4% 0.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 8.1% · Q3 3.2% · Q4 6.5% · 4Q avg 5.1%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	26.8%	20.6% 6.2 pts worse	19.6% 7.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 28.2% · Q2 29.7% · Q3 22.6% · Q4 25.8% · 4Q avg 26.8%
Percentage of long-stay residents who received an antipsychotic medication	7.4%	19.8% 12.4 pts better	16.7% 9.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 8.8% · Q2 10.0% · Q3 6.9% · Q4 3.6% · 4Q avg 7.4% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.2% 0.2 pts better	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	13.1%	18.5% 5.4 pts better	16.3% 3.2 pts better	Long Stay · 2024Q4-2025Q3 · Q2 17.9% · Q3 11.9% · Q4 7.9% · 4Q avg 13.1% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	24.2%	18.3% 5.9 pts worse	14.9% 9.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 26.3% · Q2 20.6% · Q3 22.6% · Q4 27.6% · 4Q avg 24.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	4.1%	1.7% 2.4 pts worse	1.0% 3.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 3.2% · Q2 2.7% · Q3 5.5% · Q4 4.9% · 4Q avg 4.1% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.0%	2.5% 2.5 pts better	1.7% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	31.6%	26.0% 5.6 pts worse	19.8% 11.8 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 38.8% · Q2 43.3% · Q3 13.9% · Q4 29.2% · 4Q avg 31.6%
Percentage of long-stay residents with pressure ulcers	6.8%	4.3% 2.5 pts worse	5.1% 1.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 2.7% · Q2 10.3% · Q3 7.5% · Q4 6.9% · 4Q avg 6.8% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	84.3% 15.7 pts better	81.7% 18.3 pts better	Short Stay · 2024Q4-2025Q3 · Q2 100.0% · Q3 100.0% · 4Q avg 100.0%
Percentage of short-stay residents who newly received an antipsychotic medication	0.0%	1.9% 1.9 pts better	1.6% 1.6 pts better	Short Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	87.0%	73.3% 13.7 pts better	79.7% 7.3 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 87.0%

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-09-11 · Fire 2025-09-11

0 health deficiencies

No concentrated health issue counts in this cycle.

4 fire-safety deficiencies

Top issue: Miscellaneous (2 deficiencies)

Cycle 2 Health 2024-09-19 · Fire 2024-09-19

1 health deficiencies

Top issue: Quality of Life and Care (1 deficiency)

2 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 3 Health 2023-06-22 · Fire 2023-06-22

2 health deficiencies

Top issue: Pharmacy Service (1 deficiency)

4 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-09-11

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2025-09-22

F · Potential for more than minimal harm 2025-09-11

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2025-09-22

F · Potential for more than minimal harm 2025-09-11

K711 · Miscellaneous Deficiencies

Fire Safety

Provide a written emergency evacuation plan.

Corrected 2025-10-11

F · Potential for more than minimal harm 2025-09-11

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2025-09-22

F · Potential for more than minimal harm 2024-09-19

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2024-10-03

E · Potential for more than minimal harm 2024-09-19

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-10-03

F · Potential for more than minimal harm 2023-06-22

K346 · Smoke Deficiencies

Fire Safety

Follow proper procedures when the fire alarm was out of service for more than 4 hours.

Corrected 2023-06-28

F · Potential for more than minimal harm 2023-06-22

K914 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

Corrected 2023-07-05

F · Potential for more than minimal harm 2023-06-22

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-07-05

D · Potential for more than minimal harm 2023-06-22

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2023-06-30

Inspection history

Recent health citations

G · Actual harm 2025-02-06

F677 · Quality of Life and Care Deficiencies

Health

Provide care and assistance to perform activities of daily living for any resident who is unable.

Corrected 2025-02-20

D · Potential for more than minimal harm 2023-06-22

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2023-07-10

D · Potential for more than minimal harm 2023-06-22

F758 · Pharmacy Service Deficiencies

Health

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Corrected 2023-07-10

Penalties and ownership