
Report
TheVardellReport
Royal Oaks Nursing and Rehabilitation Center
Skilled nursing facility and nursing facility
4614 NW 84th Street
Urbandale, IA 50322

TheVardellReport
Skilled nursing facility and nursing facility
4614 NW 84th Street
Urbandale, IA 50322
Life by Vardell Presents
The deeper story, beautifully organized. Available records, historical context, and questions worth asking.
This report is free. Vardell does not certify, grade or endorse; it shows what the record documents.
The Essentials
Across 12 inspections from December 2023 to August 2026, state surveyors documented 71 findings at Royal Oaks Nursing and Rehabilitation Center; 71 have a recorded correction; CMS lists 6 enforcement actions in the window.
* Partial year, through October 1, 2026.
| Year | Inspections | Findings | Of which, actual harm (level G or above) |
|---|---|---|---|
| 2023 | 1 | 5 | 2 |
| 2024 | 5 | 31 | 1 |
| 2025 | 2 | 15 | 3 |
| 2026 | 4 | 20 | 2 |
Chronology
Every inspection in the record window, newest first. A finding is a deficiency an inspector cited. CMS publishes what a complaint investigation cited, not what the complaint alleged.
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
7 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
5 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
7 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
12 findings
The same visit included a complaint investigation.
Enforcement Action
Civil money penalty, $16,907 imposed October 22, 2025. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of May 20, 2025, the nearest before the penalty date.
Enforcement Action
Civil money penalty, $202,722 imposed February 11, 2026. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of May 20, 2025, the nearest before the penalty date.
Enforcement Action
Denial of payment imposed February 11, 2026. Status: Closed, July 8, 2026. CMS does not tie a penalty to a survey; listed with the standard health inspection of May 20, 2025, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
12 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
1 finding
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
12 findings
The same visit included a complaint investigation.
Enforcement Action
Civil money penalty, $71,136 imposed December 12, 2024. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the standard health inspection of July 1, 2024, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
3 findings
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
5 findings
Enforcement Action
Civil money penalty, $34,223 imposed December 6, 2023. CMS publishes the fine, not whether it has been paid. CMS does not tie a penalty to a survey; listed with the complaint investigation of December 6, 2023, the nearest before the penalty date.
Enforcement Action
Denial of payment imposed December 6, 2023. Status: Closed, February 13, 2024. CMS does not tie a penalty to a survey; listed with the complaint investigation of December 6, 2023, the nearest before the penalty date.
Source: Health inspection results, as published by CMS (Health Deficiencies and Inspection Dates, Provider Data Catalog)
Severity levels follow the CMS scope and severity grid. A–C: potential for minimal harm. D–F: no actual harm, potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy.
Context
A repeated citation can merit attention, but context and corrective action must be reviewed before drawing a conclusion.
Inspectors cited F880 in January 2024, December 2024, May 2025, February 2026, April 2026 and June 2026. This citation covers hand hygiene, isolation practice and the home’s infection-prevention program. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F550 in January 2024, July 2024, December 2024, May 2025 and June 2026. This citation covers residents’ right to dignity, to make their own choices and to communicate. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F658 in December 2023, July 2024, December 2024, May 2025 and February 2026. This citation covers whether the home’s services meet professional standards of quality. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F689 in July 2024, October 2024, December 2024, May 2025 and June 2026. This citation covers whether residents are protected from accident hazards and supervised closely enough to prevent accidents, including falls. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F684 in October 2024, December 2024, October 2025 and February 2026. This citation covers whether residents receive the treatment their orders, preferences and goals call for. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F686 in December 2023, October 2024, April 2026 and June 2026. This citation covers how the home prevents and treats pressure injuries (bedsores). The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F690 in September 2024, February 2026, April 2026 and June 2026. This citation covers continence care, catheter care and preventing urinary tract infections. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F656 in December 2023, July 2024 and December 2024. This citation covers whether each resident has a written care plan that meets their needs, with goals that can be measured. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F677 in December 2024, February 2026 and April 2026. This citation covers help with bathing, dressing, eating and toileting for residents who cannot manage alone. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F755 in December 2023, December 2024 and June 2026. This citation covers pharmacy services and the licensed pharmacist who oversees them. The most serious of these was recorded at level J (immediate jeopardy). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F584 in December 2024 and February 2026. This citation covers whether rooms and shared spaces are kept safe, clean, comfortable and homelike. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F695 in December 2023 and May 2025. This citation covers oxygen, breathing treatments and other respiratory care. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F760 in May 2025 and April 2026. This citation covers whether residents are free from significant medication errors. The most serious of these was recorded at level G (actual harm). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F761 in December 2024 and May 2025. This citation covers how drugs are labeled and kept locked, including controlled drugs. None rose above level D (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F812 in May 2025 and August 2026. This citation covers how food is stored, prepared and served. None rose above level F (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
Inspectors cited F842 in May 2025 and October 2025. This citation covers whether resident records are complete, accurate and kept confidential. None rose above level E (no actual harm, potential for more). Each citation has a recorded correction, and a repeat after correction is worth a direct question.
For Your Next Visit
Bring these to the tour. Each one comes from something in the record; the reason is under the question.
Who leads infection control here, and how often are hand-hygiene and isolation practices audited?
Infection Control: cited in six inspections, most seriously at level E.
How do staff learn each resident’s preferences, and how is a complaint about dignity handled?
Dignity and Resident Rights: cited in five inspections, most seriously at level E.
How do you check that nurses and aides follow professional standards, and what happens when they do not?
Professional Standards: cited in five inspections, most seriously at level D.
What changed in fall prevention and supervision after the last citation, and how do you check that it is still working?
Accident Hazards and Supervision: cited in five inspections, most seriously at level G.
How do nurses make sure a doctor’s orders are carried out, and how are families told when something is missed?
Quality of Care: cited in four inspections, most seriously at level E.
How often are residents checked for pressure injuries and repositioned, and who is responsible for it?
Pressure Injury Care: cited in four inspections, most seriously at level G.
How is continence care scheduled, and how do you prevent urinary infections?
Continence and Catheter Care: cited in four inspections, most seriously at level G.
How is a care plan written and reviewed here, and how do families take part in it?
Care Plans: cited in three inspections, most seriously at level D.
How long do residents usually wait for help with bathing, dressing or the bathroom, and how is that tracked?
Help With Daily Living: cited in three inspections, most seriously at level E.
How often does the consultant pharmacist review each resident’s medications?
Pharmacy Services: cited in three inspections, most seriously at level J.
What was done about the cleanliness citation, and how are rooms and shared spaces checked now?
A Clean, Homelike Setting: cited in two inspections, most seriously at level E.
Who manages oxygen and breathing treatments on each shift, and how is the equipment checked?
Respiratory Care: cited in two inspections, most seriously at level G.
What happened after the medication error citation, and how are high-risk drugs double-checked?
Significant Medication Errors: cited in two inspections, most seriously at level G.
How are medications stored and secured, and who checks the medication carts?
Medication Labeling and Storage: cited in two inspections, most seriously at level D.
May we see the kitchen, and what do your own sanitation checks look like week to week?
Kitchen and Food Safety: cited in two inspections, most seriously at level F.
How can a family request a resident’s records, and how are they kept accurate?
Medical Records: cited in two inspections, most seriously at level E.
How many nurses and aides are on each shift, including nights and weekends, for the unit we are considering?
Insufficient nursing staff was cited in October 2025.
What led to the 2026 fine, and has it been paid?
A $202,722 civil money penalty was imposed February 11, 2026. CMS publishes the fine, not whether it has been paid. The record holds six enforcement actions in the window.
The Evidence
Inspection results and penalties are published by the Centers for Medicare & Medicaid Services from surveys conducted by the Iowa state survey agency.
Iowa state survey agency
Inspection Dec 6, 2023 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Jan 30, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Jul 1, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Sep 7, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Oct 15, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Dec 13, 2024 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection May 20, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Oct 22, 2025 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Feb 11, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Apr 9, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Jun 11, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Iowa state survey agency
Inspection Aug 6, 2026 · Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Centers for Medicare & Medicaid Services · 165580
Published Oct 1, 2026 · Retrieved Nov 1, 2026
Record windowDecember 6, 2023 – October 1, 2026
Historical coverage varies by agency and location. Missing records do not mean that no complaint or violation occurred.
Data architecture: Cierto supplies the source-backed machine-readable bundle. Life by Vardell independently creates the narrative, design, and consumer report.