Federal inspection record · CMS data as of October 1, 2026
Keystone Nursing Care Center INC
250 Fifth Street, Keystone, IA · (319) 442-3234
- Certified beds
- 55
- Residents per day
- 43
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 17, 2012
1
How this home got 5 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Iowa.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Keystone Nursing Care Center INC carries 5 inspection points. That is fewer than 92% of Iowa's 385 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Iowa: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–7 pts
- 4★ 7–21 pts
- 3★ 21–41 pts
- 2★ 41–86.5 pts
- 1★ over 86.5 pts
Bars show every rated home in Iowa by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
3 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
G
Provide care and assistance to perform activities of daily living for any resident who is unable.
Everything else, by area of care
Quality of Life and Care1D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Pharmacy Service1D
- D
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.
Inspection history
2025-09-11
0 health deficiencies · 4 fire-safety deficiencies
No concentrated health issue counts in this cycle.
2024-09-19
1 health deficiencies · 2 fire-safety deficiencies
Top issue: Quality of Life and Care (1 deficiency)
2023-06-22
2 health deficiencies · 4 fire-safety deficiencies
Top issue: Pharmacy Service (1 deficiency)
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.9 pts better | 0.5 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.8 pts better | 1.1 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.3 pts better | 95.5% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine1.6 pts better | 97.4% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.9 pts better | 0.0% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms4.2 pts better | 0.0% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight4.2 pts worse | 8.6% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.1 pts better | 20.9% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication17.9 pts better | 1.9% | 19.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened5.1 pts better | 10.1% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.9 pts worse | 18.5% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder3 pts worse | 4.4% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.7 pts better | 0.7% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8.7 pts worse | 33.7% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.8 pts better | 2.3% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine0.2 pts worse | 83.8% | 84.0% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.1 pts worse | 3.2% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine7.7 pts worse | 66.7% | 74.4% | 80.1% |
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Who owns and runs it
8 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Bruns, Tracy | Direct Ownership Interest · Individual | 0% | 1 facilities |
| Bruns, Tracy | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Bruns, Tracy | Corporate Director · Individual | 0% | 1 facilities |
| Bruns, Tracy | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Bruns, Tracy | Adp Of The SNF · Individual | 0% | 1 facilities |
| Meeker, Brian | Corporate Director · Individual | 0% | 2 facilities |
| Meeker, Brian | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Meeker, Brian | Adp Of The SNF · Individual | 0% | 2 facilities |
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Fire safety
10 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke5F
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Install corridor and hallway doors that block smoke.
- F
Install an approved automatic sprinkler system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- F
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
Miscellaneous2F
- F
Provide a written emergency evacuation plan.
- F
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems2F
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Have generator or other power source capable of supplying service within 10 seconds.
Services1D
- D
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
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