Stone Cottage Care Center
Inspection Findings
F-Tag F0558
F 0558 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
interactions, creating potential risk for misinterpretation and emotional distress for both the resident and staff. Interventions included the following, in part:Explain each step before and during hands-on care. Offer choices when possible. Maintain privacy (doors closed, curtains pulled). Date initiated: 11/24/25. Provide care in pairs for all personal care tasks including transfers, hygiene and perineal care, dressing, bed bath, and repositioning. Date initiated: 11/24/25. Validate concerns without arguing or escalating. Reinforce expectations and boundaries respectfully. Avoid defensiveness if reports are made, respond per policy. Date initiated: 11/24/25. The Care Plan, revealed additional Focus area for Resident #5 being at an increased fall risk and refuses use of motion detector alarm, preferring to notify staff by calling the facility with his cellular phone. Interventions included: Honor preference to use a cell phone to call the facility for assistance instead of a motion detector. Date initiated: 12/04/25. Date revised: 12/17/25. Respond promptly to Resident #5's call to the facility when he asks for assistance. Date initiated: 12/04/25. Date revised: 12/17/25. Social Services: Support Resident #5's autonomy and document ongoing preference for alternatives to alarms.
Date initiated: 12/04/25. Date revised: 12/17/25. During an interview on 12/22/25 at 10:30 AM, Resident #5 stated he had a rough start when first admitted to the facility due to hygiene care and wound care not always completed in a timely manner but felt this had improved. Resident #5 reported using his voice activated program on cell phone to call the facility for help when needed and denied concerns with this call system. When Resident #5 attempted to demonstrate use of his cell phone for a call light system, after several attempts, he was unable to use the voice activation command to unlock and use his phone.
Resident #5 required another person to restart his phone before the voice command system was able to be used. During an interview on 12/23/25 at 3:00 PM, the Director of Nursing (DON) revealed the expectation of staff to answer call lights within 15 minutes of resident activation. During an interview on 12/23/25 at 3:00 PM, the facility administrator reported that the facility was currently updating the call light system from a pull string lever to a push button. The administrator confirmed knowledge of Resident #2 requesting to use breath-activated call system upon admission and knowledge of Resident #2 having concern that the motion sensor alarm provided was not functioning properly. Review of the facility policy titled Answering the Call Light, not dated, revealed the policy Purpose Statement was to ensure timely responses the the residents' requests and needs. The Section A. General Guidelines, directed the following: Upon admission and periodically as needed, explain and demonstrate use of the call light to the residents. Ask the resident to return the demonstrationExplain to the resident that a call system is also located in his/her bathroom. Be sure that the call light is plugged in and functioning at all times. Ensure that the call light is accessible to the resident when in bed, from the toilet, from the shower or bathing facility, and from the floor.Report all defective call lights to the nurse supervisor promptly.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
12/23/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Stone Cottage Care Center
900 South Stone Street Sigourney, IA 52591
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0725
F 0725
specialized rehabilitation services, activities/recreational, social, therapy, environmental, etc.) are staffed to ensure resident needs are met.
Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
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If continuation sheet
Stone Cottage Care Center in Sigourney, IA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Sigourney, IA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Stone Cottage Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.