Keystone Nursing Care Center Inc
250 Fifth Street, Keystone, IA 52249 · Benton County · (319) 442-3234
55 certified beds, about 44 residents a day · For profit - Corporation · Medicare and Medicaid since 2012
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165604 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on September 11, 2025, inspectors cited 0 health deficiencies (the Iowa average is 6.5, the national average 9.2).
Of 3 health citations since June 2023, 1 was rated as actual harm or immediate jeopardy to residents.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.75 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.33 of those hours.
38.6% of nursing staff left within the year CMS measured (Iowa average 44.0%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 3 health citations on file.
September 11, 2025Standard inspection · 0 citations
February 6, 2025Complaint inspection · 1 citation
- G Provide care and assistance to perform activities of daily living for any resident who is unable.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to properly transfer 1 of 4 residents reviewed for mechanical lift transfers (Resident #1). Staff transferred Resident #1 into the shower without the use of a mechanical lift and a second staff person assisting directly with the transfer as directed in her Care Plan. This resulted in a fall with a fractured femur. The facility reported a census of 39 residents.
September 19, 2024Standard inspection · 0 citations
June 22, 2023Standard inspection · 2 citations
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record review, resident and staff interviews and facility policy review, the facility failed to notify the Physician for elevated blood sugars for 1 of 2 residents reviewed for insulin usage (Resident #205). The facility reported a census of 48. Findings Include: The Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #205 scored 14 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated cognitively intact. The MDS identified medical diagnosis of diabetes mellitus. The MDS revealed the resident received insulin injections 7 out 7 days. The Care Plan entry dated 12/17/21 revealed a focus problem of diabetes mellitus. Interventions dated 12/17/21 documented daily administration of Novolog injections (insulin medication) and finger tip blood sugars monitored per Medical Doctor (MD) orders. [...]
- 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.
Inspectors wroteBased on clinical record review and staff interview, the facility failed to document non-pharmacological interventions attempted prior to the administration of as needed (PRN) anxiolytics (medications used to treat anxiety) for 1 of 2 residents reviewed for prn anxiolytic use(Resident #26). The facility reported a census of 48 residents. Findings Include: The Minimum Data Set (MDS) Assessment tool, dated 4/20/23, listed diagnoses for Resident #26 which included Parkinson's disease, mild cognitive impairment, and adult failure to thrive. The MDS listed the resident's Brief Interview for Mental Status (BIMS) score as 7 out of 15, indicating severely impaired cognition. Care Plan entries, dated 8/8/22, stated the resident utilized as needed medications such as lorazepam (an anxiolytic) and directed staff to administer the medication as ordered. [...]
Fire safety inspections
10 fire safety citations on file: 4 on September 11, 2025, 2 on September 19, 2024, 4 on June 22, 2023.
Every fire safety citation10 citations
- F Inspect, test, and maintain automatic sprinkler systems.
- F Install corridor and hallway doors that block smoke.
- F Provide a written emergency evacuation plan.
- F Have simulated fire drills held at unexpected times.
- 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.
- 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.
- D Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Iowa | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.75 | 3.82 | 3.86 |
| Registered nurses | 0.33 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.31 | 3.37 | 3.42 |
| Nurse aides | 2.76 | ||
| Licensed practical nurses | 0.66 | ||
| Nursing staff turnover (share who left in a year) | 38.6% | 44.0% | 45.8% |
| Registered nurse turnover | 66.7% | 42.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.05 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.94 on weekdays and 3.31 on weekends, 16% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 1.9% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.20 in April to June 2025 to 3.75 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.75 | 0.33 | 3.94 | 3.31 | 1.9% | 0 of 90 | 44 |
| Oct to Dec 2025 | 3.90 | 0.34 | 4.04 | 3.53 | 0.0% | 0 of 92 | 42 |
| Jul to Sep 2025 | 4.33 | 0.38 | 4.56 | 3.72 | 0.0% | 0 of 92 | 40 |
| Apr to Jun 2025 | 4.20 | 0.35 | 4.35 | 3.81 | 0.1% | 1 of 91 | 42 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Iowa, Jan to Mar 2026 | 3.80 | 0.71 | 3.98 | 3.36 | 4.7% | 0.3% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Iowa | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 19.7 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 4.8 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.7 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 0.0 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 3.4 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 9.1 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.5 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 3.8 | 19.4 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.8 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.9 | 2.1 | 1.8 |
Owners and operators
Legal business name: KEYSTONE NURSING CARE CENTER INC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Bruns, Tracy | Direct ownership interest | Individual | 03/26/2012 | |
| Bruns, Tracy | Managing control - governing body | Individual | 03/06/2012 | |
| Bruns, Tracy | Corporate director | Individual | 03/16/2012 | |
| Meeker, Brian | Corporate director | Individual | 03/16/2012 | |
| Bruns, Tracy | Operational/managerial control | Individual | 03/16/2012 | |
| Meeker, Brian | Operational/managerial control | Individual | 03/16/2012 | |
| Bruns, Tracy | Adp of the SNF | Individual | 03/26/2012 | |
| Meeker, Brian | Adp of the SNF | Individual | 04/02/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on February 6, 2025: "Provide care and assistance to perform activities of daily living for any resident who is unable."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 1 problem in this area, most recently on June 22, 2023: "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."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.31 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- Belle Plaine Specialty Care Belle Plaine, 8 mi · 4 of 5 stars · 20 citations
- The Vinton Lutheran Home Vinton, 14 mi · 2 of 5 stars · 13 citations
- Virginia Gay Nursing & Rehab, LLC Vinton, 15.1 mi · 3 of 5 stars · 6 citations
- Rose Haven Nursing Home Marengo, 16.8 mi · 3 of 5 stars · 26 citations
- Sunrise Hill Care Center Traer, 18.5 mi · 4 of 5 stars · 3 citations
- Sunny Hill Care Center Tama, 19.8 mi · 1 of 5 stars · 14 citations
- Accura Healthcare of Toledo Toledo, 20 mi · 3 of 5 stars · 16 citations
- Laporte City Specialty Care La Porte City, 20.3 mi · 4 of 5 stars · 3 citations
Iowa contacts for a concern about a nursing home
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Iowa Department of Inspections, Appeals, and Licensing, Health Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Iowa Office of the State Long-Term Care Ombudsman, 866-236-1430. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Iowa Health Facility Database, Entity Search, where Iowa publishes its own records on licensed homes.
Common questions
- What is Keystone Nursing Care Center Inc's Medicare star rating?
- CMS rates Keystone Nursing Care Center Inc 5 out of 5 stars overall, with 5 for health inspections, 3 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Keystone Nursing Care Center Inc get at its last inspection?
- 0 health deficiencies at the standard inspection on September 11, 2025. The Iowa average is 6.5.
- Has Keystone Nursing Care Center Inc been fined?
- CMS lists no fines in the last three years.
- Does Keystone Nursing Care Center Inc accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Keystone Nursing Care Center Inc?
- CMS lists 8 owners and managers. Legal business name: KEYSTONE NURSING CARE CENTER INC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.