Average — CMS composite of the measures below.
A standard survey is most likely before around September 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Happy Siesta Health Care Center during CMS and state inspections, most recent first.
Staff failed to follow professional food safety standards by handling ready-to-eat food, utensils, and other surfaces with the same pair of gloves and not washing hands between glove changes during meal preparation and service. Both a staff member and the Dietary Manager were observed touching bread, plates, and trays with gloved hands without proper glove changes or hand hygiene, contrary to FDA Food Code requirements.
A resident with severe cognitive impairment and multiple comorbidities experienced a gradual decline, including lethargy, poor intake, and difficulty maintaining posture, over several days. Despite these changes, staff delayed notifying the physician, with communication not initiated until after the weekend. Laboratory tests ordered after physician notification revealed critical abnormalities, resulting in the resident's transfer to the hospital.
A resident with severe cognitive impairment and multiple psychiatric diagnoses experienced increasing lethargy, weakness, and poor oral intake after a psychotropic medication dosage increase. Staff documented these changes but did not consistently implement care plan interventions or notify the psychiatric ARNP managing the medications, resulting in delayed response to the resident's deteriorating condition.
A resident with severe cognitive impairment and a history of falls was repeatedly found on the floor, sometimes with injuries, but staff did not consistently complete incident reports or assessments unless the event was unwitnessed. Staff often did not notify the nurse or follow facility policy for documenting and reviewing such incidents, resulting in a failure to ensure proper assessment and oversight.
A resident with severe cognitive impairment and multiple medical conditions, including cancer, stroke, and dementia, experienced a fall resulting in a C2 cervical fracture while being transported in the facility's passenger van. The incident occurred when the van driver accelerated during a turn, causing the resident's wheelchair to tip over. The investigation revealed that the Q'straint loops for securement were not properly applied, and staff involved had discrepancies in recalling whether all restraints were correctly used. The facility lacked specific van policies prior to the incident, highlighting gaps in ensuring resident safety during transportation.
Failure to Follow Food Safety Standards During Meal Preparation and Service
Penalty
Summary
Staff in the facility's kitchen failed to adhere to professional standards for food service safety during food preparation and serving. Observations revealed that a staff member, while wearing gloves, handled various items including utensils, milk, and bread, and placed meat and bread into a food processor. The same staff member was seen tearing bread with gloved hands and, during meal service, both she and the Dietary Manager handled bread and plates with gloved hands, touching multiple surfaces without changing gloves between tasks. The Dietary Manager also handled bread and plates, then pushed trays across the counter, and continued to handle food items without changing gloves. Further observations showed that the staff member changed gloves several times but did not wash her hands between glove changes, despite handling utensils, bread bags, and ready-to-eat food. The staff member acknowledged awareness of the correct procedure, stating she knew food should not be touched if other surfaces had been contacted with gloves on. The Dietary Manager confirmed that food should not be touched under these circumstances. These actions were not in compliance with the FDA Food Code 2022, which requires single-use gloves to be used for only one task and discarded when soiled or when an interruption occurs.
Failure to Timely Notify Physician of Resident's Change in Condition
Penalty
Summary
A deficiency occurred when facility staff failed to notify a physician in a timely manner regarding a resident's significant change in condition. The resident, who had severe cognitive impairment, aphasia, schizophrenia, and was on multiple psychoactive and opioid medications, exhibited a gradual but clear decline over several days. Documentation showed the resident became increasingly lethargic, weak, and had difficulty maintaining an upright position, with poor oral intake and periods of apnea. Despite these changes, there was a delay in contacting the physician, with initial communication attempts not made until several days after the onset of symptoms. Progress notes indicated that the resident's condition began to deteriorate on a Friday, with staff noting lethargy, weakness, and decreased responsiveness. Over the weekend, the resident continued to decline, showing poor appetite, increased sleepiness, and difficulty with transfers and self-care. Staff communicated with the resident's Power of Attorney but did not reach out to the physician until the following Monday, at which point a fax was sent and follow-up calls were made. Orders for laboratory tests were not received until the next day, and the results revealed critical abnormalities, including severe hypernatremia and renal dysfunction, prompting hospital transfer. Interviews with staff confirmed that the resident's decline was observed by multiple caregivers, but action to notify the physician was delayed, particularly over the weekend when regular nursing staff were not present. The facility's policy required nursing staff to notify the physician of changes in a resident's condition, but this was not followed in a timely manner. The physician later stated that earlier notification could have led to earlier intervention. The deficiency was identified based on record review, staff interviews, and the facility's own policy documentation.
Failure to Implement Resident-Specific Psychotropic Medication Monitoring
Penalty
Summary
The facility failed to ensure that staff implemented resident-specific interventions for the use of psychotropic medications for one resident with severe cognitive impairment and multiple psychiatric diagnoses, including schizophrenia and adverse effects from antipsychotics. The resident's care plan required staff to observe and report adverse reactions to psychoactive medications, such as lethargy, fatigue, and drowsiness. Despite these requirements, the clinical record showed that the resident experienced increasing lethargy, weakness, poor appetite, and difficulty maintaining an upright position over several days following an increase in psychotropic medication dosage. Staff documented multiple episodes of the resident being lethargic, having periods of apnea, poor oral intake, and difficulty responding to questions or maintaining posture. Bruising was also noted, and the resident required increased assistance with activities of daily living. Although staff noted these changes and attempted to contact the resident's power of attorney and physician, there was a delay in escalating care and notifying the psychiatric ARNP who managed the resident's medications. The ARNP later confirmed that she had not been notified of the resident's condition change during the relevant timeframe. The facility's policy required appropriate administration, evaluation, and monitoring of psychotropic medications in collaboration with the interdisciplinary team. However, the documentation lacked evidence that the psych ARNP was informed of the resident's significant change in condition after the medication increase, and staff did not consistently implement the care plan interventions for monitoring and reporting adverse reactions. This failure contributed to a delay in addressing the resident's deteriorating condition.
Failure to Assess and Document Incidents for Cognitively Impaired Resident
Penalty
Summary
The facility failed to complete proper assessments following incidents involving a resident with severe cognitive impairment, aphasia, schizophrenia, and a history of multiple falls. The resident was known to frequently lower herself to the floor, sometimes requiring assistance to get up, and had poor safety awareness and spatial judgment. Despite repeated incidents where the resident was found on the floor, staff did not consistently complete incident reports or assessments unless the event was unwitnessed, and sometimes did not notify the nurse when the resident was found on the floor. On one occasion, the resident was found with significant bruising to her right foot and hip, but due to her condition, staff were unable to obtain a description of what had occurred. Staff interviews revealed a pattern of not reporting or assessing incidents when the resident was observed lowering herself to the floor, as this was considered typical behavior for her. The facility's policy required documentation and assessment of all accidents and incidents, including details such as the nature of the injury, circumstances, witness accounts, and notifications. However, these procedures were not consistently followed for this resident, resulting in a failure to ensure all incidents were properly assessed and reviewed as required by facility policy.
Inadequate Nursing Supervision Leads to Fall Incident During Transportation
Penalty
Summary
The deficiency identified in the report pertains to inadequate nursing supervision leading to a fall incident involving Resident #1 at the facility. Resident #1, with a history of severe cognitive impairment and multiple medical conditions including cancer, stroke, and dementia, was assessed as a high fall risk. Despite being identified as such, Resident #1 experienced a fall while riding in the facility's passenger van, resulting in a C2 cervical fracture that required surgical intervention and placement of a halo brace. The incident occurred as the van driver accelerated during a turn, causing Resident #1's wheelchair to tip over backwards, resulting in head injuries. The investigation revealed that the facility had implemented interventions such as ordering Q'straint loops for securement, attaching antitippers to chairs, and providing staff education on accident policies. However, it was found that the Q'straints were not applied properly during the incident, leading to Resident #1's fall. Staff interviews indicated that the van driver and activity assistant involved in the incident had not ensured proper securement of Resident #1's wheelchair, with discrepancies in recalling whether all restraints were correctly applied. The facility's lack of van policies prior to the incident and the subsequent training provided to staff highlighted gaps in ensuring resident safety during transportation.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 46 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Remsen
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Heartland Care Center | 8.3 mi | ★★★★★ | 8 | 0 |
| Good Samaritan - Lemars | 9.2 mi | ★★★★★ | 3 | 0 |
| Accura Healthcare Of Le Mars | 9.7 mi | ★★★★★ | 0 | 0 |
| Prairie Ridge Care Center | 14.6 mi | ★★★★★ | 0 | 0 |
| Kingsley Specialty Care | 15.1 mi | ★★★★★ | 7 | 1 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Happy Siesta Health Care Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.