Holy Spirit Retirement Home - Sioux City Nursing Home
General Information
UPDATEFederal Provider Number
165266
Provider Name
HOLY SPIRIT RETIREMENT HOME
Provider Address
1701 WEST 25TH STREET
SIOUX CITY, IA 51103
SIOUX CITY, IA 51103
Provider Phone Number
7122522726
Provider SSA County
960
Provider County Name
Woodbury
Ownership Type
Non profit - Church related
Number of Certified Beds
94
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HOLY SPIRIT RETIREMENT HOME INC
Date First Approved to Provide Medicare and Medicaid services
1996-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.81793
Reported LPN Staffing Hours per Resident per Day
0.80924
Reported RN Staffing Hours per Resident per Day
1.07120
Reported Licensed Staffing Hours per Resident per Day
1.88043
Reported Total Nurse Staffing Hours per Resident per Day
5.69837
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05272
Expected CNA Staffing Hours per Resident per Day
2.48206
Expected LPN Staffing Hours per Resident per Day
0.61974
Expected RN Staffing Hours per Resident per Day
0.83798
Expected Total Nurse Staffing Hours per Resident per Day
3.93978
Adjusted CNA Staffing Hours per Resident per Day
3.77431
Adjusted LPN Staffing Hours per Resident per Day
1.08379
Adjusted RN Staffing Hours per Resident per Day
0.95515
Adjusted Total Nurse Staffing Hours per Resident per Day
5.83016
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-04-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Casa De Paz Health Care Center
2121 West 19th Street |
SIOUX CITY IA 51103 | 0.4 mile away
Westwood Nursing & Rehab Cente
4201 Fieldcrest Drive |
SIOUX CITY IA 51104 | 1.6 miles away
Touchstone Living Center
1800 Indian Hills Drive |
SIOUX CITY IA 51104 | 2.6 miles away
Hallmark Care Center
3800 Indian Hills Drive |
SIOUX CITY IA 51104 | 3.3 miles away
Sunrise Retirement Community
5501 Gordon Drive East |
SIOUX CITY IA 51106 | 5.6 miles away
Countryside Nursing And Rehabilitation Center
6120 Morningside Avenue |
SIOUX CITY IA 51106 | 6.7 miles away
Embassy Healthcare Community
206 Port Neal Road |
SERGEANT BLUFF IA 51054 | 9 miles away
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