Dunklau Gardens
Dunklau Gardens
Skilled Nursing Facility • 106 Licensed Beds
Hospital-Based
450 East 23rd Street, Fremont, NE
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
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Dunklau Gardens

Skilled Nursing Facility • 106 Licensed Beds
Hospital-Based
450 East 23rd Street,
Fremont, NE
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
View details →
About

Dunklau Gardens – Medicare Certified Since 1992

Dunklau Gardens is a Medicare and Medicaid certified skilled nursing facility located in Fremont, Nebraska. This facility has been serving the community for 34 years. A Medicare-certified skilled nursing facility provides 24-hour nursing care, rehabilitation services, and assistance with activities of daily living for patients who need skilled nursing or rehabilitation services on a daily basis.

This is a hospital-based skilled nursing facility, meaning it operates within or adjacent to a hospital. Hospital-based SNFs typically provide access to hospital services, specialists, and advanced diagnostic equipment, making them well-suited for patients with complex medical needs or those requiring close physician oversight during recovery.

This facility has 106 certified beds with a current occupancy rate of 78% (averaging 82 residents per day), which is moderate. Skilled nursing facilities provide 24-hour nursing care for patients who need rehabilitation services after a hospital stay or ongoing care for chronic conditions. Services include skilled nursing, physical therapy, occupational therapy, speech therapy, and assistance with daily activities.

Staffing Levels: Based on CMS payroll data, this facility provides approximately 4.79 hours of total nursing care per resident per day (3.33 hours from CNAs, 0.32 hours from LPNs, 1.14 hours from RNs). Physical therapy staffing is 0.07 hours per resident per day. This represents above-average staffing compared to national benchmarks.

Medicare Quality Ratings: According to CMS, Dunklau Gardens has an overall quality rating of 5 out of 5 stars, which is much above average compared to other nursing homes nationwide. Individual category ratings are: health inspection: 4 stars, staffing: 5 stars, quality measures: 3 stars.

Medicare Coverage: Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay of at least 3 days. Days 1-20 are fully covered by Medicare, days 21-100 require a daily coinsurance payment. Many residents also use Medicaid, private insurance, or pay privately for long-term stays.

Questions to Ask: When visiting a nursing home, ask about: staff-to-resident ratios and RN coverage around the clock, how they handle medical emergencies, activities and therapy programs, how they communicate with families, their approach to falls prevention, and policies for managing resident complaints.

Visit Medicare Care Compare to view detailed ratings, inspection reports, staffing data, and compare this facility with others in the area.

Quality ratings and facility data are updated periodically by CMS. We recommend verifying current information at Medicare Care Compare.

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Local Comparison Snapshot

How Dunklau Gardens compares to 118 facilities in Rural NE

Click a measure name to jump to details • Hover over for definitions

Measure
This Facility
Area Avg
Comparison
Overall Rating
Medicare 5-star rating
5
2.9
Quality Measures
Clinical outcomes & safety
3
2.7
Health Inspections
State survey results
4
2.9
Staffing
Nurse-to-resident ratio
5
3.3
Staffing Hours (per resident/day)
RN Hours
Registered nurses
1.14 hrs
0.68 hrs
LPN/LVN Hours
Licensed practical nurses
0.32 hrs
0.63 hrs
CNA Hours
Certified nursing assistants
3.33 hrs
2.58 hrs
Total Nursing Hours
CNA + LPN + RN combined
4.79 hrs
3.89 hrs
Agency/Contractor Usage
Lower agency use often indicates more stable, consistent care
RN Agency Use
% of RN hours from contractors
17.8 %
8.1 %
LPN/LVN Agency Use
% of LPN hours from contractors
6.3 %
16.6 %
CNA Agency Use
% of CNA hours from contractors
0 %
12.4 %
Staff Stability & Occupancy
Staff Turnover
Annual nursing staff turnover
35 %
48 %
Occupancy Rate
Percentage of beds filled
78 %
70 %
Better than Area
Near Average
Below Area Average

Data from CMS Medicare Compare and Payroll-Based Journal. Area averages based on 118 facilities in Rural NE.
Ratings and staffing data typically reflect the most recent quarterly reporting period available.

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Medicare Star Ratings

Official CMS ratings based on health inspections, staffing, and quality measures

Data as of December 2025

What do Medicare star ratings measure?
Medicare rates nursing homes on a 1-5 star scale based on three key areas: health inspection results, staffing levels, and quality measures like falls and infections.
How often are ratings updated?
CMS updates nursing home ratings monthly. Ratings can change based on new inspection results, staffing data from payroll records, and clinical quality outcomes.
Overall Rating
5/5
Quality Measures
3/5
Health Inspections
4/5
Staffing
5/5

Star Ratings History

Quarterly performance from 2013-2026

View on Medicare.gov
Overall
Health Inspections
Quality
Staffing
Source: Centers for Medicare & Medicaid Services

How Does This Facility Compare?

Compared to 118 other nursing homes in Rural NE

Why compare to local facilities?
Local comparisons account for regional staffing markets and demographics. A facility performing above local averages often indicates strong management and quality care relative to area standards.
Dunklau Gardens
Rural NE Average

Based on CMS Medicare star ratings. Higher ratings indicate better performance.

Staffing Hours per Resident Day

Dunklau Gardens
Rural NE Average

Staffing data from CMS Payroll-Based Journal. Higher hours generally indicate more direct care time.

Staff Turnover Rate

Dunklau Gardens
Rural NE Average

Lower turnover rates generally indicate a more stable workforce and better continuity of care.

Agency/Contract Staff Usage

Dunklau Gardens
Rural NE Average

Lower agency usage often indicates better staff retention. High agency rates (>30%) may suggest staffing challenges.

Agency Staff Trends

Historical agency/contract staff usage by role

What does agency usage indicate?
Agency/contract staff fill temporary staffing gaps. Lower percentages typically indicate a stable, permanent workforce. Facilities with consistently high agency usage (>30%) may face staff retention challenges, though temporary spikes can occur during seasonal illness or transitions.
CNA
LPN
RN

Data from CMS Payroll-Based Journal (PBJ). Agency % = contractor hours / total hours.

Direct Care Staffing

Average minutes of direct nursing care per resident per day

Data as of December 2025

Understanding staffing levels: Higher staffing is associated with better quality outcomes. Research suggests around 4.1 hours of total nursing care per resident per day as a quality benchmark. Compare this facility's staffing to local averages to assess relative care levels.
200
minutes/day
CNAs
Certified Nursing Assistants
19
minutes/day
LPNs
Licensed Practical Nurses
68
minutes/day
RNs
Registered Nurses
4
minutes/day
PTs
Physical Therapists

Staffing Trends

Direct care minutes per resident per day

CNAs
LPNs
RNs
PTs
Source: Centers for Medicare & Medicaid Services

Occupancy Rate History

Average daily residents as a percentage of certified beds

Understanding occupancy: Higher occupancy can indicate strong community reputation and demand. Very low occupancy may affect financial stability, while extremely high occupancy could mean limited bed availability.
Dunklau Gardens
Rural NE Average (69.7%)

Data from CMS Provider Info files. Occupancy = Average Residents per Day / Certified Beds.

Staff Turnover History

Annual percentage of nursing staff who left the facility

Data as of December 2025

Understanding turnover: Lower turnover rates generally indicate a more stable workforce and better continuity of care. High turnover can affect care quality and resident relationships. The national average for nursing homes is around 50-60%.
All Nursing Staff
Registered Nurses (RN)
Area Average

Data from CMS Payroll-Based Journal. Turnover = staff who left during the year / total staff.

Services

Comprehensive skilled nursing services, rehabilitation programs, and medical care in FREMONT

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