Continental Springs, LLC
Nursing Home, Assisted Living, Memory Care, Respite Care & Skilled Nursing · South Sioux City, NE
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.

Continental Springs, LLC

Nursing Home, Assisted Living, Memory Care, Respite Care & Skilled Nursing · South Sioux City, NE
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
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Continental Springs, LLC accepts Medicaid, Medicare, and private pay.

Overview of Continental Springs

Under Tammy Jo Palmersheim’s ownership, Continental Springs is a 77-bed nursing home in South Sioux City, Nebraska. It’s situated on G Street with a Walk Score of 73, so most errands are easily walkable, with the neighborhood reachable to visiting family. Medicaid, Medicare, and private pay are welcome, giving families numerous ways to afford care.

Continental Springs specializes in rehabilitation and respite services, with 24-hour staffing to support residents’ daily needs. Total nursing care averages 3 hours 50 minutes per resident day, with registered nurses providing 36 minutes of that care. More support comes from nurse aides offering 2 hours 38 minutes per resident daily, with licensed practical nurses contributing 21 minutes each day. This staffing model provides consistent hands-on care for residents convalescing from illness or injury, plus those staying longer term. The average stay length is 308 days, indicating a blend of short-term rehabilitation admissions and longer-term residents. With 47 residents in its 77 licensed beds, the facility currently operates at 61 percent occupancy. Dining is centered around home-cooked meals served in the social center, a focal point of daily life. Daily amenities span personal laundry service, scheduled transportation to local destinations, and housekeeping support. Such services are tailored to ease life’s practical and social aspects for occupants and visiting families.

The facility’s inspection history spans 15 years of data. A recent inspection confirmed the home complies with no deficiencies. Earlier surveys had raised some concerns regarding environmental cleanliness, resident dignity, fire safety, and emergency preparedness, though a subsequent complaint investigation found the specific allegation unsubstantiated, and the facility complied on that matter. Families touring the community can inquire how these areas are handled every day.

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Health Inspection Info Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Staffing Info Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Quality Measures Info Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.

Staffing hours breakdown

Info Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day — compared to state averages

Total nursing care / resident Info Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
3h 50m per day
Rank #87 / 130Nurse hours — State benchmarkedThis home is ranked 87th out of 130 homes in Nebraska. Shows adjusted nurse hours per resident per day benchmarked to the Nebraska average, with a ranking across 130 Nebraska facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs avg

6 of 6 metrics below state avg

Staff typeHours / Day / Residentvs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 36m per day ▼ 16% State avg: 43m per day · National avg: 41m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 21m per day ▼ 51% State avg: 43m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 2h 38m per day ▼ 5% State avg: 2h 46m per day · National avg: 2h 20m per day
Weekend Total Nursing Info Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours. 3h 8m per day ▼ 13% State avg: 3h 37m per day · National avg: 3h 26m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation. 1m per day ▼ 61% State avg: 3m per day · National avg: 4m per day
Weekend RN Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent. 24m per day ▼ 18% State avg: 29m per day · National avg: 28m per day

Capacity and availability

Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
308 days
Bed community size
77-bed community Rank #90 / 228Bed count — State benchmarkedThis home is ranked 90th out of 228 homes in Nebraska. Shows this facility's certified or reported bed count compared to other Nebraska facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A larger shared setting that may offer more common spaces and organized community services.
Walk Score
Walk Score: 73 / 100 Rank #35 / 298Walk Score — State benchmarkedThis home is ranked 35th out of 298 homes in Nebraska. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Nebraska facilities. Higher scores benefit residents, families, and staff.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate
61%
Rank #150 / 196Occupancy rate — State benchmarkedThis home is ranked 150th out of 196 homes in Nebraska. Shows this facility's occupancy rate versus the Nebraska average, with its Statewide rank out of 196. Higher occupancy signals strong local demand and financial stability.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Lower than the Nebraska average: 70.3%
Occupied beds
47 / 77
Average occupied beds in Nebraska homes 54 beds

License Details

Facility TypeNursing Home
CountyDakota
CMS Certification Number285082
Certification TypeCertification

Ownership & Operating Entity

Continental Springs, LLC is administered by Administrator Ericka Niles.

Owner NameContinental Springs, LLC

Safety & Compliance

Emergency Systems24-hour emergency response system in each apartment and suite.

Payment & Insurance

2 services
Accept Medicaid
Accept Medicare

Therapy & Rehabilitation

2 services
Rehabilitation Services
Respite Care

Staffing & Medical

1 service
24-Hour Staffing

Contact Information

Fax(402) 494-8830

Additional Policies & Features

Pets Allowed
HousekeepingYes

Amenities & Lifestyle

Personal Laundry Service
Scheduled Local Transportation
Housekeeping
Activities
Dining Services

Contact Continental Springs, LLC

Inspection History

In Nebraska, the Department of Health and Human Services, Division of Public Health conducts regular inspections to ensure nursing and assisted living facilities meet state and federal standards.

Since 2011 · 15 years of data 95 deficiencies

Inspection Scorecard Info This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Nebraska state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2011 vs. Nebraska state average
Overall vs. NE average 2 Worse Metrics worse than Nebraska average:
• Total deficiencies (83% above)
• Deficiencies per year (80% above)
0 Better No metrics in this bucket.
Latest Inspection March 27, 2025

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This FacilityNE Averagevs. NE Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 9552 This facility has 83% more total deficiencies than a typical Nebraska assisted living residence (95 vs. NE avg 52).↑ 83% worse
Deficiencies per year Info Average deficiencies per year since 2011. 6.33.5 This facility has 80% more deficiencies per year than a typical Nebraska assisted living residence (6.3 vs. NE avg 3.5).↑ 80% worse

Inspection Reports Summary Info An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

  • The most recent inspection on March 27, 2025, reported no deficiencies and confirmed licensure renewal with a 77-bed capacity.
  • The April 9, 2018 survey cited 18 deficiencies including resident dignity, environmental cleanliness, fire safety, and emergency preparedness violations.
  • A February 11, 2020 complaint investigation found the allegation of failure to ensure prompt emergency care unsubstantiated and the facility compliant.

Health Inspection History

Inspections since 2022
Total health inspections 4

State average N/A


Last Health inspection on Oct 2024

Total health citations
10 Rank #31 / 135Health citations — State benchmarkedThis home is ranked 31st out of 135 homes in Nebraska. Shows this facility's total health deficiency citations benchmarked to the Nebraska State average, with a ranking across all 135 NE facilities. Lower citation counts earn a better rank.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Citations per inspection
2.5 Rank #18 / 135Citations per inspection — State benchmarkedThis home is ranked 18th out of 135 homes in Nebraska. Shows average deficiency citations per CMS inspection for this facility versus the Nebraska mean across 135 facilities with citation data. Lower is better.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

8 of 10 citations resulted from standard inspections; 1 of 10 resulted from complaint investigations; and 1 of 10 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 4 years)
Critical health citations
0
In line with State average

State average: N/A


Serious health citations
0
In line with State average

State average: N/A

0 critical citations State average: N/A

0 serious citations State average: N/A

10 moderate citations State average: N/A

0 minor citations State average: N/A
Citations history (last 4 years)
Infection Control moderate citation Oct 31, 2024
Corrected

Nutrition moderate citation Oct 31, 2024
Corrected

Abuse/Neglect moderate citation Mar 19, 2024
Corrected

Nutrition moderate citation Aug 24, 2023
Corrected

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 68
Employees 50
Contractors 18
Staff to resident ratio 1.31 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 27
Average shift 7.5 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 18,660

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info All 6 RN Staff are full-time employees. No contractors work on this role. 6
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info 4 total: 3 full-time employees and 1 contractor. 4
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.1 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info 19 total: 16 full-time employees and 3 contractors. 19
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.4 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

6%

1,113 contractor hours this quarter

Certified Nursing Assistant: 3 Physical Therapy Aide: 3 Speech Language Pathologist: 3 Physical Therapy Assistant: 3 Respiratory Therapy Technician: 3 Medication Aide/Technician: 1 Licensed Practical Nurse: 1 Qualified Social Worker: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Medication Aide/Technician171186,46692100%8
Certified Nursing Assistant163195,34592100%7.4
Registered Nurse6061,90292100%8.4
Dietitian4041,3108795%7.5
Licensed Practical Nurse3141,0288087%9.1
Administrator1015406672%8.2
RN Director of Nursing1015326267%8.6
Clinical Nurse Specialist1014225459%7.8
Speech Language Pathologist0333795661%6.5
Nurse Practitioner1013705054%7.4
Physical Therapy Assistant0332215155%4.3
Respiratory Therapy Technician033882830%3
Physical Therapy Aide033453033%1.3
Qualified Social Worker011131718%0.7
18 Medication Aide/Technician
% of Days 100%
19 Certified Nursing Assistant
% of Days 100%
6 Registered Nurse
% of Days 100%
4 Dietitian
% of Days 95%
4 Licensed Practical Nurse
% of Days 87%
1 Administrator
% of Days 72%
1 RN Director of Nursing
% of Days 67%
1 Clinical Nurse Specialist
% of Days 59%
3 Speech Language Pathologist
% of Days 61%
1 Nurse Practitioner
% of Days 54%
3 Physical Therapy Assistant
% of Days 55%
3 Respiratory Therapy Technician
% of Days 30%
3 Physical Therapy Aide
% of Days 33%
1 Qualified Social Worker
% of Days 18%

Penalties and fines

Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 9.5
16% better than State average

State average: 11.3

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 18.4
21% better than State average

State average: 23.3

Long-stay resident measures
Below average State avg: 2.8 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 18.0%
14% better than State average

State average: 20.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 18.2%
18% better than State average

State average: 22.1%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 19.0%
29% better than State average

State average: 26.9%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 3.7%
18% better than State average

State average: 4.5%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 5.4%
25% worse than State average

State average: 4.3%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 6.1%
99% worse than State average

State average: 3.1%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 2.4%
56% better than State average

State average: 5.4%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 1.8%
59% better than State average

State average: 4.4%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 33.1%
67% worse than State average

State average: 19.8%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 58.7%
37% worse than State average

State average: 93.2%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 94.0%
In line with State average

State average: 96.1%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.74
In line with State average

State average: 1.80

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 1.34
31% better than State average

State average: 1.95

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 13.5%
83% worse than State average

State average: 80.7%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 6.9%
193% worse than State average

State average: 2.4%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 53.9%
29% worse than State average

State average: 75.9%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 21.5%
In line with State average

State average: 20.9%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 0.0%
100% better than State average

State average: 11.6%

Breakdown by payment type

Medicare

13% of new residents, usually for short-term rehab.

Typical stay 2 - 3 months

Private pay

54% of new residents, often for short stays.

Typical stay 3 - 4 months

Medicaid

33% of new residents, often for long-term daily care.

Typical stay 2 - 3 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 52
Medicare
5
9.6% of residents
Medicaid
45
86.5% of residents
Private pay or other
2
3.8% of residents
Programs & Services
Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

For-profit
Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$5.0M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$2.1M
For-profit Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$5.0M Rank #85 / 133Revenue — State benchmarkedThis home is ranked 85th out of 133 homes in Nebraska. Shows this facility's annual revenue compared to the Nebraska average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$2.1M
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$136.6K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #133 / 133Payroll — State benchmarkedThis home is ranked 133rd out of 133 homes in Nebraska. Shows total annual staff payroll benchmarked to the Nebraska average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$149.5K 3% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #133 / 133Payroll % — State benchmarkedThis home is ranked 133rd out of 133 homes in Nebraska. Shows payroll as a percentage of revenue versus the Nebraska average. Well-run Nebraska facilities typically land around 66–74% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Nebraska that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$7.0M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$7.2M

Who this home usually serves

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

Most new residents arrive under private pay (54% of admissions), and a typical private pay stay runs around 3 - 4 months.

Admissions
54 total

Coverage residents most often arrive under.

Medicare 13%
Private pay 54%
Medicaid 33%
Discharges
61 total

Coverage residents most often leave under.

Medicare 7%
Private pay 48%
Medicaid 46%

Places of interest near Continental Springs, LLC

Address 0.0 miles from city center Info Estimated distance in miles from South Sioux City's city center to Continental Springs, LLC's address, calculated via Google Maps.

Calculate Travel Distance to Continental Springs, LLC

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Frequently Asked Questions about Continental Springs, LLC

Is Continental Springs, LLC in a walkable area?

Continental Springs, LLC has a walk score of 73. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the occupancy rate at Continental Springs, LLC?

Continental Springs, LLC's occupancy is 61%.

Does Continental Springs, LLC operate as a for-profit or non-profit?

Continental Springs, LLC is registered as a for-profit in NE.

Who is the administrator of Continental Springs, LLC?

Administrator Ericka Niles is the administrator of Continental Springs, LLC.

How many beds does Continental Springs, LLC have?

Continental Springs, LLC has 77 beds.

Are there photos of Continental Springs, LLC?

Yes — there are 3 photos of Continental Springs, LLC in the photo gallery on this page.

What is the address of Continental Springs, LLC?

Continental Springs, LLC is located at 3200 G Street, South Sioux City, NE 68776.

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