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Complaint Investigation

Holy Spirit Retirement Home

April 30, 2026 · Sioux City, IA · 1701 West 25th Street
Citations 2
CMS Rating 3/5
Beds 78
Provider ID 165266
Healthcare Facility
Holy Spirit Retirement Home
Sioux City, IA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Holy Spirit Retirement Home in Sioux City, IA — inspection on April 30, 2026.

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.

Inspection Findings

FF0550
Resident Rights Deficiencies

stated if she asked her to change the brief she would have changed it but she did not ask her to

12:42 PM the Director of Nursing (DON) stated Staff N ripped the brief and Resident #3 stated she

stated Staff N should have changed the brief.

The DON acknowledge a lack of dignity did occur when Staff N refused to change Resident #3's brief.Review of a policy provided by the facility dated 2/20 titled, Quality of Life - Dignity documented residents are treated with dignity and respect at all times.

The facility's culture is one that supports and encourages humanization and individuation of residents, and honors resident choice, preferences, values, and beliefs.

This begins with the initial admission and continues throughout the resident's stay.

Some examples of ways in which respect for choices and values are exercised included personal grooming - residents are groomed as they wish to be groomed.

Residents are encouraged and assisted to dress in their own clothes.

165266 04/30/2026

Holy Spirit Retirement Home 1701 West 25th Street Sioux City, IA 51103

Observation on 04/27/2026 at 2:01 PM showed Staff P, Certified Nursing Assistant, applied a sling to Resident #21 then locked the right wheel of the mechanical stand.

Using the controls, the CNA lifted the resident from the chair, unlocked the right wheel, then positioned the resident over the toilet.

The CNA then lowered the resident onto the toilet and locked the right wheel.

When the resident finished, the CNA lifted the resident from the toilet, unlocked the right wheel, positioned the resident over the chair, locked the right wheel, then lowered the resident.

The CNA failed to keep the mechanical stand brakes unlocked during transfer.

The Operator's Instructions for the mechanical stand instructed staff to only lock the brakes when raising and lowering the resident during ambulation.In an interview on 4/29/26 at 2:31 PM, the Director of Nursing (DON) reported staff should follow the operator's instructions and keep the wheels unlocked during transfers.

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 Holy Spirit Retirement Home or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.