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Complaint Investigation

Casa De Paz Health Care Center

August 21, 2025 · Sioux City, IA · 2121 West 19th Street
Citations 2
CMS Rating 2/5
Beds 71
Provider ID 165174
Healthcare Facility
Casa De Paz Health Care Center
Sioux City, IA  ·  View full profile →
Inspection Summary

Casa De Paz Health Care Center in Sioux City, IA — inspection on August 21, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0550
Resident Rights Deficiencies
Potential for More Than Minimal Harm

According to the facility policy titled: Dignity, revised on February 2021, staff promote maintain and protect resident privacy, including bodily privacy during assistance with personal care and during treatment procedures.

Demeaning practices and standard of care that compromise dignity were prohibited.

Staff were expected to promote dignity and respect and help the residents to keep urinary catheter bags covered.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Casa DE Paz Health Care Center

2121 West 19th Street Sioux City, IA 51103

SUMMARY STATEMENT OF DEFICIENCIES

disease, heart failure, dementia, seizure disorder and anxiety disorder.The Care Plan updated on 4/24/25, showed that Resident #9 had the potential for impaired skin integrity and was at risk for edema, swelling and pain.

Staff were to administer treatments as ordered.

The August MAR/TAR for Resident #9 showed the following orders and missed treatments:Order dated 6/27/24 at 7:30 AM, methol-zinc oxide ointment apply to gluteal crease one time day for skin care.

The treatment was not completed on the 3rd, 16th and 17thOrder dated 6/24/24 at 7:30 AM, [NAME] hose apply in the morning and elevate legs when resting.

Not done on 3rd, 16th or 17th.Order dated 3/24/25 at 7:00 PM, Biofeeze gel apply to back and knee twice a day.

Not done on 3rd, 16 or 17th.4) According to the MDS dated [DATE], Resident #10 had a BIMS score of 13 (moderate cognitive deficit.) She was totally dependent on staff for dressing, hygiene, toileting and transfers.

She had an indwelling catheter and her diagnoses included: neurogenic bladder, dementia, anxiety disorder, schizophrenia, and respiratory failure.The Care Plan for Resident #10 last updated on 6/3/25, showed that the resident was on hospice services due to terminal condition.

Staff were to administer medications as ordered, indwelling catheter, provide catheter care per policy.

She had the potential for impaired skin integrity, administer treatments as ordered and monitor for effectiveness.

The August MAR/TAR for Resident #10 showed the following orders and missed treatments:Order dated 7/19/25 at 7:00 AM, apply Steri-strip to skin tear on left forearm twice a day.

The treatment was only done once a day on the 3rd, 10th, 16th and 17thOrder dated 2/26/25 at 7:30 AM, apply lotion to areas affected by incontinence daily.

Not completed on 3rd, 16th and 17th.Order dated 6/3/25 at 7:30 AM, apply lotion to dry areas on both feet daily.

Not completed on 3rd, 16th or 17th.On 8/21/25 at 9:20 AM, Staff C.

Licensed Practical Nurse (LPN) demonstrated that many options the nurses had in the electronic chart, to indicated the reason if/when a treatment or medication was not given.

The choices then transferred over into the nursing notes.

She said that with those options, the space on the MAR/TAR should never be left blank with no explanation.8/21/25 at 10:40 AM the Director of Nursing (DON) said that they had a new nurse that she suspected did not understand the documentation of treatments.

She had a charge nurse that was responsible for supervising the new staff member and she would be providing some education to the nurses.A facility policy titled: Medication and Treatment Orders, dated July 2016, showed that orders for medications and treatments would be consistent with principles of safe and effective order writing.A facility policy titled: Indwelling Catheter Insertion, Female Resident; Preparation, Review the residents record and verify physicians order for the procedure.

Facility ID:

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 Sioux City, 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 Casa De Paz Health Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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