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

Holy Spirit Retirement Home

Sioux City, IA · 78 certified beds · Last Life Safety survey April 30, 2026

CMS Certification Number 165266 · first certified April 1996

Also on this campus

The same campus holds a state-licensed assisted living facility, with its own state record on the Assisted Living Index: Holy Spirit Retirement Home (1701 West 25th Street). Matched by the street address the two records share. The records are separate and are never added together.

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Corporation

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

15
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
5
Inspection & testing records
Of the citations on file

Position within IA

15 citations — more than 65% 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

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 2 citations; the earlier surveys in the window averaged 6.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens March 2027 — about 6 months from now. This facility’s last Life Safety survey was April 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

3 of the 15 citations on file are 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)

5 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 15 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

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 facility15IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility15
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
82024-0552025-0522026-04
Citations at each Life Safety survey
Survey dateCitations
May 22, 20248
May 15, 20255
April 30, 20262

Most-cited tags

Most-cited tags at this facility
K-03542K-03462K-03511E-00391K-09181K-03241K-03631K-03451
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.22025-05-15
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.22025-05-15
K-0351Install an approved automatic sprinkler system.12026-04-30
E-0039Conduct testing and exercise requirements.12024-05-22
K-0918Have generator or other power source capable of supplying service within 10 seconds.12024-05-22
K-0324Provide properly protected cooking facilities.12024-05-22
K-0363Install corridor and hallway doors that block smoke.12025-05-15
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12024-05-22

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 8
  • Emergency Preparedness Deficiencies 3
  • Gas, Vacuum, and Electrical Systems Deficiencies 2
  • Construction Deficiencies 1
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies8
Emergency Preparedness Deficiencies3
Gas, Vacuum, and Electrical Systems Deficiencies2
Construction Deficiencies1
Miscellaneous Deficiencies1

Every citation on file

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

April 30, 2026 — 2 citations

Citations issued on April 30, 2026
TagWhat the surveyor checksStatus
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (May 31, 2026)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (May 31, 2026)

May 15, 2025 — 5 citations

Citations issued on May 15, 2025
TagWhat the surveyor checksStatus
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (June 14, 2025)
K-0133Install a two-hour-resistant firewall separation.Deficient, Provider has date of correction (June 14, 2025)
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (June 14, 2025)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (June 14, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (June 14, 2025)

May 22, 2024 — 8 citations

Citations issued on May 22, 2024
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (June 11, 2024)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (June 12, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (June 5, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 10, 2024)
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (June 10, 2024)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (June 10, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (June 10, 2024)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (June 27, 2024)

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