B
75/100

Holy Spirit Retirement Home Inspection Report, Violations & Safety Grade (Sioux City, Iowa)

1701 West 25th Street, Sioux City, Iowa 51103

Phone: 7122522726

CMS Overall:3/5

Overview & Bed Count

Certified Beds
78
Avg Residents/Day
54.5
Ownership
Non profit - Corporation
Provider Type
Medicare and Medicaid
County
Woodbury
Sprinkler Systems
Yes
Special Focus
None
Abuse Citation
No

CMS Star Ratings

Overall3/5
Health2/5
Staffing5/5
Quality4/5

Nurse Staffing Check

MetricThis FacilityIowa AvgDifference
RN Hours per Resident per Day0.820.74+0.08
Total Nurse Hours per Resident per Day4.643.86+0.78
CMS Staffing Rating5/53.8/5-
Nursing Staff Turnover55.2%44.1%-

Health Citation History

30 health citations on record

DateCategoryDescriptionSeverity
2026-04-30Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.E – Moderate Harm Potential
2026-04-30Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2026-04-30Infection Control DeficienciesProvide and implement an infection prevention and control program.E – Moderate Harm Potential
2026-04-30Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2026-04-30Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.D – Moderate Harm Potential
2026-04-30Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.D – Moderate Harm Potential
2026-04-30Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D – Moderate Harm Potential
2025-10-07Resident Assessment and Care Planning DeficienciesSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.E – Moderate Harm Potential
2025-05-15Quality of Life and Care DeficienciesEnsure residents do not lose the ability to perform activities of daily living unless there is a medical reason.E – Moderate Harm Potential
2025-05-15Nutrition and Dietary DeficienciesEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.E – Moderate Harm Potential
2025-05-15Administration DeficienciesHave the Quality Assessment and Assurance group have the required members and meet at least quarterlyE – Moderate Harm Potential
2025-05-15Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D – Moderate Harm Potential
2025-05-15Quality of Life and Care DeficienciesProvide care and assistance to perform activities of daily living for any resident who is unable.D – Moderate Harm Potential
2025-05-15Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D – Moderate Harm Potential
2025-05-15Quality of Life and Care DeficienciesProvide safe and appropriate respiratory care for a resident when needed.D – Moderate Harm Potential
2025-05-15Quality of Life and Care DeficienciesProvide specialized rehabilitative services by qualified personnel, when ordered for a resident by a doctor.D – Moderate Harm Potential
2025-05-15Infection Control DeficienciesProvide and implement an infection prevention and control program.D – Moderate Harm Potential
2024-05-22Infection Control DeficienciesProvide and implement an infection prevention and control program.F – Moderate Harm Potential
2024-05-22Freedom from Abuse, Neglect, and Exploitation DeficienciesDevelop and implement policies and procedures to prevent abuse, neglect, and theft.E – Moderate Harm Potential
2024-05-22Nutrition and Dietary DeficienciesEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.E – Moderate Harm Potential
2024-05-22Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2024-05-22Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2024-05-22Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.D – Moderate Harm Potential
2024-05-22Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D – Moderate Harm Potential
2024-05-22Quality of Life and Care DeficienciesEnsure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.D – Moderate Harm Potential
2024-05-22Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential
2024-05-22Resident Assessment and Care Planning DeficienciesSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D – Moderate Harm Potential
2024-02-08Quality of Life and Care DeficienciesProvide care and assistance to perform activities of daily living for any resident who is unable.E – Moderate Harm Potential
2024-02-08Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.D – Moderate Harm Potential
2024-02-08Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.D – Moderate Harm Potential

Fire Safety Citation History

15 fire safety citations on record

DateCategoryDescriptionSeverity
2026-04-30Smoke DeficienciesInstall an approved automatic sprinkler system.F – Moderate Harm Potential
2026-04-30Miscellaneous DeficienciesHave simulated fire drills held at unexpected times.F – Moderate Harm Potential
2025-05-15Emergency Preparedness DeficienciesConduct risk assessment and an All-Hazards approach.F – Moderate Harm Potential
2025-05-15Construction DeficienciesInstall a two-hour-resistant firewall separation.F – Moderate Harm Potential
2025-05-15Smoke DeficienciesFollow proper procedures when the fire alarm was out of service for more than 4 hours.F – Moderate Harm Potential
2025-05-15Smoke DeficienciesFollow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.F – Moderate Harm Potential
2025-05-15Smoke DeficienciesInstall corridor and hallway doors that block smoke.F – Moderate Harm Potential
2024-05-22Emergency Preparedness DeficienciesDevelop and maintain an Emergency Preparedness Program (EP).F – Moderate Harm Potential
2024-05-22Emergency Preparedness DeficienciesConduct testing and exercise requirements.F – Moderate Harm Potential
2024-05-22Smoke DeficienciesHave approved installation, maintenance and testing program for fire alarm systems.F – Moderate Harm Potential
2024-05-22Smoke DeficienciesFollow proper procedures when the fire alarm was out of service for more than 4 hours.F – Moderate Harm Potential
2024-05-22Smoke DeficienciesFollow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.F – Moderate Harm Potential
2024-05-22Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.F – Moderate Harm Potential
2024-05-22Gas, Vacuum, and Electrical Systems DeficienciesEnsure that testing and maintenance of electrical equipment is performed.F – Moderate Harm Potential
2024-05-22Smoke DeficienciesProvide properly protected cooking facilities.E – Moderate Harm Potential

Total Penalties & Fines

$0
Total Fine Amount (CMS)
0
Number of Fines
0
Total Penalties

No penalty records found.

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