Keystone Nursing Care Center Inc
- Q2 2025: 4.20
- Q3 2025: 4.33
- Q4 2025: 3.90
- Q1 2026: 3.75
- Q2 2025: 41.49
- Q3 2025: 39.68
- Q4 2025: 42.02
- Q1 2026: 44.16
Keystone Nursing Care Center Inc reported 3.75 HPRD in Q1 2026. This level is above the CMS case-mix benchmark (3.05 HPRD) and in the 56th percentile of Iowa nursing homes.
Direct staff excludes Admin/DON. State minimums via MACPAC (2022) may reflect calculated HPRD equivalents. Direct staff excludes Admin/DON. State minimums via MACPAC may reflect calculated HPRD equivalents.
- Focus on multi-quarter patterns, not a single point.
- Total staffing combines RN, LPN, and nurse aide hours.
- State minimums are reference lines, not compliance findings.
CMS Case-Mix
Staffing vs. case mix
By staffing role
CMS case-mix reflects resident acuity under PDPM. The ratio is a reference point; large gaps may flag pressure points and should be read alongside staffing trends and role mix. under PDPM. The ratio is a reference point; large gaps may flag pressure points and should be read alongside staffing trends and role mix.
Ownership
Keystone Nursing Care Center Inc
CMS owner data roles and percentages are reported filings, not proof of who operates the facility or care quality.CMS owner filings; not proof of who operates.
| Name | Type | Role | Since | |
|---|---|---|---|---|
| Brian W Meeker | Individual | 100% ownership interest; Operational/managerial control; Corporate director; ADP of the SNF | 03/16/2012 | |
| Tracy L Bruns | Individual | 100% ownership interest; Operational/managerial control; Corporate director; ADP of the SNF | 03/16/2012 |
How these figures are calculatedMethods, definitions, and data sources
Staffing from CMS Payroll-Based Journal (PBJ) public nurse files (2017–2026), plus Provider Information (September 2026 processing snapshot) and chain data where shown. State staffing context via March 2022 compendium. Methodology · PBJ guide.
Metrics
- Hours Per Resident Day (HPRD): Total staff hours ÷ average residents. Example: 350 hours for 100 residents = 3.5 HPRD.
- Direct Care (excl. Admin, DON): Hours per resident day for direct care staff only (RN, LPN, CNA, NAtrn, MedAide), excluding administrative and supervisory roles.
- Contract Staff %: Share of hours provided by contract staff.
- Census: Average number of residents during the period.
Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.
Data transparency
The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.
Trend charts omit quarters with implausible submitted HPRD (total/direct below 0.25; RN, LPN, and aide use role floors and neighbor-quarter rules). Full criteria.
Rankings, within-state percentiles, CMS flags (including abuse icon): How metrics are calculated.