Brookestone of David City

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

Therapy staffing: this home’s payroll records show 0.41 therapist hours per resident per day in 2026Q1 — more than 71% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 26% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 86 beds and averages 56.5 residents a day — about 66% occupied, or roughly 30 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.20 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.58 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.92 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.59 hrs/resident/day on weekends vs 4.44 on weekdays — 19% thinner on weekends. RN hours go from 0.71 to 0.28 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 31% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

• Potential for harm · D2025-02-13 · tag F0641 — isolated
  Ensure each resident receives an accurate assessment.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Licensure Reference Number 175 NAC 12-006.09B Based on record review and interview; the facility failed to ensure the Minimum Data Set (MDS-a comprehensive assessment of each resident's functional capabilities used to develop a resident's plan of care) reflected hypoglycemic (medication used to help reduce the amount of sugar present in the blood) medication use for two (Resident 23 and Resident 28) of 15 sampled residents. The facility census was 57. Findings are: A review of the CMS's (Centers for Medicare and Medicaid [NAME]) RAI (Resident Assessment Instrument) Version 3.0 Manual, dated October 2024, revealed the following regarding hypoglycemic (including insulin) medication use: Check if a hypoglycemic medication was taken by the resident at any time during the 7-day observation period (or since admission/entry or reentry if less than 7 days.) In an interview on 2/13/25 at 8:38 AM, the Assistant Director of Nursing/MDS Coordinator (ADON/MDS) confirmed that the facility follows the RAI Manual when…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-02-13 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Licensure Reference Number 175 NAC 12-006.09D3(5) Based on record review and interview; the facility failed to follow the bowel protocol to prevent constipation for two (Resident 23 and 35) of two sampled residents. The facility census was 57. Findings are: A. Review of Resident 23's Bowel Movement Task, dated 1/13/25 to 2/11/25, revealed that [gender] did not have a bowel movement (BM) between the following dates: 1/15-1/18/25, 1/26-2/1/25 and 2/3-2/8/25. Review of Resident 23's Order Summary Report, dated 2/11/25, revealed the following medications used to promote bowel movements: -Milk of Magnesia Oral Suspension 400 milligram (mg)/5 milliliters (ml), give 30ml by mouth every 24 hours as needed, -Dulcolax Rectal Suppository 10mg insert 1 suppository rectally every 24 hours as needed. A review of Resident 23's January 2025 Medication Administration Record (MAR) revealed that [gender] received a Dulcolax suppository on 1/19/25, Milk of Magnesia on 1/23/25 and 1/31/25 and all were recorded that they were effective in promoting a BM. A review of Resident 23's electronic health record…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-02-13 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Licensure Reference Number 175 NAC 12-006.18(B) Licensure Reference Number 175 NAC 12-006.18(D) Based on observation, record review and interviews; the facility failed to ensure hand hygiene (HH-using an alcohol-based hand rub (ABHR) or washing hands with soap and water) was completed in a manner to prevent the potential for cross-contamination during peri-care (washing the genitals and anal area) for one (Resident 19) of one sampled residents for incontinence cares and failed to complete peri-care in a manner to prevent cross-contamination during wound care for one (Resident 15) of one sampled residents for wound care. The facility census was 57. Findings are: A review of the facility's Hand Hygiene competency, dated 12/2019, revealed the following: -Hand hygiene using antimicrobial soap and water: 4. Lather and rub hands together for full 20 seconds, -When to wash hands: before each resident contact, after touching a resident or handling their belongings, after any contact with body fluids, after handling…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2024-03-12 · tag F0661 — isolated
  Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Licensure Reference 175 NAC 12-006.09C3a Based on record review and interview, the facility failed to ensure a Discharge Summary including a recapitulation (a short summary) of stay was completed for 1 (Resident 46) of 1 sampled residents upon discharge from the facility. The facility census was 47. Findings are: A record review of Resident 46's Electronic Health Record (EHR) revealed the resident was admitted on [DATE] with diagnoses of: aftercare following surgery on the circulatory system, a history of a coronary artery bypass graft (a medical procedure to improve blood flow to the heart), high blood pressure, atrial fibrillation (an irregular heartbeat), and type 2 diabetes mellitus (a disease that occurs when your blood glucose, also called blood sugar, is too high). A record review of Resident 46's EHR revealed that the resident was discharged to their home on [DATE]. A record review of Resident 46's EHR, including the Assessments tab, revealed no Discharge Summary form or recapitulation of stay. In an…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2023-04-13 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — the official record, unedited, may be distressing

  LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D7a Based on observation, interview, and record review, the facility failed to implement gait belt usage during transfers for 1 (Resident 14) of 3 sampled residents. The facility identified a census of 42. Findings are: Record review of Compressive Care Plan saved electronically on 4/12/23 revealed that resident returned from the hospital on 3/13/23 with a fracture to the Right Fibula. Record review of Physical Therapy (PT) O notes reveals Resident goal is to transfer from bed to chair, with moderate assist with one assist and a FWW (front wheeled walker). An observation 4/11/23 at 12:50 PM revealed the PT transferred Resident 14 to the chair without a gait belt (a belt that allows for a more controlled transfer) on the resident. The resident and PT did use Resident 14's walker during the transfer. 4/11/23 1:04 PM An Interview was conducted with the Director of Nursing (DON). During the interview the DON reported a gait belt should have been used during the transfer.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2023-04-13 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
  Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D3 Based on record review and interview the facility failed to implement an individualized toileting plan for 1 (Resident 14) of 1 sampled resident. The facility identified census of 42. Findings are: Record review of the care plan confirmed no individualized toileting plan documented. Record review of [NAME] (a way to communicate the residents care to the NA) reveals no individualized toileting plan. Record review of Minimum Data Set (MDS), a federally mandated assessment tool used for care planning) dated 3/30/23 revealed the facility assessed the following; -Brief Interview on Mental Status (BIMS) was a 10. According to the MDS Manual a score 8-12 indicates moderately impaired cognition. -Required extensive assist with toileting. -Frequently incontinent of bladder. -Occasionally incontinent of bowel. -No toileting program has been attempted. Record review of Resident 14's bladder assessment dated [DATE] revealed that Resident 14 was incontinent and should be…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to VETTER SENIOR LIVING — 22 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

CMS files one row per role, so the 19 rows in the source record cover these 8 parties — each is shown once here with every role it holds. Nothing is omitted.

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

This home reported $349K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2024. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2024). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in NE