Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Kennybrook Village

Grimes, IA · 40 certified beds · Last Life Safety survey January 22, 2026

CMS Certification Number 165605 · first certified March 2012

Also on this campus

The same campus holds a state-licensed assisted living facility, with its own state record on the Assisted Living Index: Kennybrook Village (200 SW Brookside Drive). Matched by the street address the two records share. The records are separate and are never added together.

Ownership

Operated by PIVOTAL HEALTH CARE · For profit - Individual

No change of ownership on CMS record since January 1, 2016, when the records begin.

7
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
4
Inspection & testing records
Of the citations on file

Position within IA

7 citations — more than 19% of the 387 certified nursing homes in IA. Compared within IA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Holding steadyabout the same at the latest survey as at its earlier surveys in the window.

The latest survey found 2 citations; the earlier surveys in the window averaged 2.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens December 2026 — about 2 months from now. This facility’s last Life Safety survey was January 2026. Facilities in IA are typically surveyed 11–13 months after the last one (median 12), measured over 700 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

Emergency preparedness

1 of the 7 citations on file is Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

2 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 7 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

How that compares

Citations on file over three years

Compared with the median facility in IA, and nationally. Surveyors differ markedly between states, so the IA figure is the meaningful one.

This facility7IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility7
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
32023-0922025-0122026-01
Citations at each Life Safety survey
Survey dateCitations
September 28, 20233
January 9, 20252
January 22, 20262

Most-cited tags

Most-cited tags at this facility
K-09231K-09181E-00261K-09111K-07121K-03531K-03211
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0923Have proper medical gas storage and administration areas.12023-09-28
K-0918Have generator or other power source capable of supplying service within 10 seconds.12026-01-22
E-0026Establish roles under a Waiver declared by secretary.12025-01-09
K-0911Meet requirements for the installation and maintenance of electrical systems.12023-09-28
K-0712Have simulated fire drills held at unexpected times.12026-01-22
K-0353Inspect, test, and maintain automatic sprinkler systems.12025-01-09
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.12023-09-28

What the citations cover

Citations by CMS category
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Smoke Deficiencies 2
  • Emergency Preparedness Deficiencies 1
  • Miscellaneous Deficiencies 1
Citations by CMS category
CategoryCitations
Gas, Vacuum, and Electrical Systems Deficiencies3
Smoke Deficiencies2
Emergency Preparedness Deficiencies1
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

January 22, 2026 — 2 citations

Citations issued on January 22, 2026
TagWhat the surveyor checksStatus
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (January 27, 2026)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 4, 2026)

January 9, 2025 — 2 citations

Citations issued on January 9, 2025
TagWhat the surveyor checksStatus
E-0026Establish roles under a Waiver declared by secretary.Deficient, Provider has date of correction (January 21, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Waiver has been granted (February 14, 2025)

September 28, 2023 — 3 citations

Citations issued on September 28, 2023
TagWhat the surveyor checksStatus
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (October 16, 2023)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (October 16, 2023)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (October 16, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.