The Palm at Regency Square

Assisted Living in Nebraska

CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Palm at Regency Square

Assisted Living in Nebraska

CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and 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.

Overview of The Palm at Regency Square

The Palm at Regency Square is a senior living facility located in South Sioux City, NE. It offers assisted living services to support residents in their daily activities while promoting independence. The facility is part of Avid Healthcare Group, which is committed to providing quality care.
(402) 494-1136

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.
1/5 ▼ 1.8 Nebraska average: 2.8/5
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.
1/5 ▼ 1.8 Nebraska average: 2.8/5
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.
2/5 ▼ 1.1 Nebraska average: 3.1/5
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.
1/5 ▼ 1.7 Nebraska average: 2.7/5

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 Nebraska state averages

Total nursing care / resident Info This home is ranked 81st out of 129 homes in Nebraska.

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 53m per day
Rank #81 / 129Nurse hours — state benchmarkedThis home is ranked 81st out of 129 homes in Nebraska.Shows adjusted nurse hours per resident per day benchmarked to the Nebraska average, with a ranking across 129 Nebraska SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.
This facility Nebraska avg (4h 20m per day)
vs Nebraska avg
-11%

2 of 6 metrics below state avg

Standout metric RN (Weekend) is +38% above state avg
Staff typeHours / dayvs 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. 45m per day ▲ 5% 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. 51m per day ▲ 19% 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 7m per day ▼ 23% State avg: 2h 46m per day · National avg: 2h 20m per day
Total Nursing (Weekend) 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 27m per day ▼ 5% 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. 3m per day ■ Avg State avg: 3m per day · National avg: 4m per day
RN (Weekend) 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. 40m per day ▲ 38% State avg: 29m per day · National avg: 28m per day

Capacity and availability

Avg. Length of Stay
111 days

Who this home usually serves

TYPE OF STAY

Mostly long-term care residents

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

Might be optimal for
Long-term daily care Ongoing support needs

Breakdown by payment type

Medicare

20% of new residents, usually for short-term rehab.

Typical stay 24 days

Private pay

38% of new residents, often for short stays.

Typical stay 3 - 4 months

Medicaid

42% of new residents, often for long-term daily care.

Typical stay 4 - 5 months

Finances and operations

Privately-owned community
Operated by a business corporation.
Home revenue
$2.8M
Operating loss
-$231.5K
Privately-owned community Operated by a business corporation.
Home revenue
$2.8M Rank #125 / 132Revenue — state benchmarkedThis home is ranked 125th out of 132 homes in Nebraska.Shows this facility's annual revenue compared to the Nebraska SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.
Operating loss
-$231.5K
Payroll costs Info The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations. Rank #126 / 132Payroll — state benchmarkedThis home is ranked 126th out of 132 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.
$1.2M
44.3% of revenue Rank #70 / 132Payroll % — state benchmarkedThis home is ranked 70th out of 132 homes in Nebraska.Shows payroll as a percentage of revenue versus the Nebraska average. Well-run SNFs often land around 55–65%. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.
Other operating costs Info All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$1.8M
Total costs $3.0M
Bed community size
38-bed community
A moderately sized community that may balance personal attention with shared amenities and social activities.

About this community

Occupancy

Occupancy rate
121%
Rank #96 / 134Occupancy rate — state benchmarkedThis home is ranked 96th out of 134 homes in Nebraska.Shows this facility's occupancy rate versus the Nebraska average, with its statewide rank out of 134. Higher occupancy signals strong local demand and financial stability.
Higher than the Nebraska average: 70.3%
Occupied beds
46 / 38
Average residents 54 per day

License Details

Facility TypeAssisted Living Facilities
StatusActive
CountyDakota
License NumberALF438
CMS Certification Number285076

Ownership & Operating Entity

The Palm at Regency Square is administrated by Matthew Gieselman, Administrator.

Staffing

Key information about the people who lead and staff this community.

Leadership

ContactMikel Ardley

Contact Information

Fax(402) 494-1239

Contact The Palm at Regency Square

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.

22 visits/inspections Info Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.

Latest inspection

Date February 19, 2025

77 deficiencies

Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.

Nebraska average: 52 deficiencies

3.5 deficiencies per inspection

Nebraska average: 4.0 deficiencies per inspection

Inspection Report Summary for The Palm at Regency Square

The most recent inspection on February 19, 2025, found The Palm at Regency Square met all statutory requirements for skilled nursing facility licensing with no deficiencies noted. Earlier inspections showed a mixed history with several citations primarily related to medication administration errors, fire and life safety code issues, and delays in submitting investigations. Complaint investigations over the years were mostly unsubstantiated, with no enforcement actions or fines listed in the available reports. Prior deficiencies included medication errors, fire safety violations, and documentation issues, but the facility was generally compliant with abuse protection and resident care requirements. The absence of deficiencies in the latest report suggests improvement in regulatory compliance over time.

Health Inspection History

Inspections
Total health inspections 8

State average 4.3


Last Health inspection on Sep 2025

Total health citations
33 Rank #114 / 134Health citations — state benchmarkedThis home is ranked 114th out of 134 homes in Nebraska.Shows this facility's total health deficiency citations benchmarked to the Nebraska state average, with a ranking across all 134 NE SNFs. Lower citation counts earn a better rank.

State average 18.2

Citations per inspection
4.12

State average 4.19


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

17 of 33 citations resulted from standard inspections; 8 of 33 resulted from complaint investigations; and 8 of 33 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 3 years)
Critical Health citations More info
1 Rank #1 / 49Severe citations — state benchmarkedThis home is ranked 1st out of 49 homes in Nebraska.Shows citations where actual resident harm occurred, compared to the Nebraska average and ranked across 49 SNFs statewide. Even a single severe citation is significant — lower is always better.
400% worse than State average

State average: 0.2


Serious Health citations More info 0
100% better than State average

State average: 0.5

1 critical citation More info State average: 0.2

0 serious citations More info State average: 0.5

32 moderate citations More info State average: 17.2

0 minor citations More info State average: 0.2
Citations history (last 3 years)
Quality of Care moderate citation Info Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs. Sep 23, 2025
Corrected

Infection Control moderate citation Info Issues related to preventing and controlling infections, including hygiene practices and safety protocols. Aug 20, 2025
Corrected

Nursing Services moderate citation Info Issues related to the availability and quality of nursing staff and the care they provide. Aug 20, 2025
Corrected

Pharmacy moderate citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Aug 20, 2025
Corrected

Compare Assisted Living around Nebraska The information below is reported by the Nebraska Department of Health and Human Services, Division of Public Health.

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The Palm at Regency Square
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

South Sioux City38No-- 100.0% -Matthew Gieselman, Administrator-22101177
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Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

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Financial Assistance for
Assisted Living in Nebraska

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Aged and Disabled Waiver

Nebraska Medicaid A&D Waiver

Age 65+ or disabled
General Nebraska resident, Medicaid- eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $4,000 individual, higher than most states
NE

Higher asset limit; rural access focus.

Benefits
Personal care (5-7 hours/day) Respite (240 hours/year) Adult day care (~$60/day) Home aides

Nebraska Respite Network

NE Respite Network

Age Caregiver of someone 60+
General Nebraska resident.
Income Limits No strict limit; prioritizes low-income.
Asset Limits Not applicable.
NE

Lifespan respite focus; limited funding.

Benefits
In-home respite (4-6 hours/day) Adult day care (~$60/day) Short-term facility care (up to 5 days)

Personal Assistance Services (PAS)

Nebraska Personal Assistance Services

Age 19+ (65+ for seniors focus)
General Nebraska resident, Medicaid-eligible, needs help with 1+ ADL (e.g., bathing, dressing).
Income Limits (2025) ~$1,255/month (100% FPL, individual); spenddown allowed.
Asset Limits $4,000 (individual), $6,000 (couple) (excludes home up to $688,000, car).
NE

Family can be paid caregivers; statewide via DHHS.

Benefits
Personal care (4-6 hours/day) Limited homemaker services Respite (~200 hours/year)

Program of All-Inclusive Care for the Elderly (PACE)

Nebraska PACE (Immanuel Pathways)

Age 55+
General Nebraska resident (specific counties), NFLOC, safe with PACE support.
Income Limits (2025) ~$2,829/month (Medicaid-eligible); private pay option available.
Asset Limits $4,000 (individual), $6,000 (couple).
NE

Only in Douglas, Sarpy, parts of Cass/Pottawattamie/Washington Counties.

Benefits
Personal care (5-7 hours/day) Medical care Meals Transportation Respite Therapies

Medicare Savings Program (MSP)

Nebraska Medicare Savings Program

Age 65+ or disabled
General Nebraska resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
NE

Three tiers; no waitlist; includes Extra Help for Part D.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Senior Community Service Employment Program (SCSEP)

Nebraska SCSEP

Age 55+
General unemployed, low-income, Nebraska resident.
Income Limits (2025) ~$1,983/month 125% FPL
Asset Limits Not specified; income-focused.
NE

Priority for veterans, rural residents; AARP partnership.

Benefits
Paid training (~20 hours/week at ~$7.25/hour) Job placement

VA Aid and Attendance (A&A) and Housebound Benefits

Nebraska VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General Nebraska resident, wartime service, need for ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth limit
NE

High veteran demand in rural areas.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living)

Places of interest near The Palm at Regency Square

Address 126.8 miles from city center Info Estimated distance in miles from SOUTH SIOUX CITY's city center to The Palm at Regency Square's address, calculated via Google Maps.

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Staffing Data (Q2 2025)

This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.

Total staff 77
Employees 57
Contractors 20
Staff to resident ratio 1.75:1
19% worse than Nebraska average

Nebraska average ratio: 2.15:1

Avg staff/day 25
Average shift 8.2 hours
5% better than Nebraska average

Nebraska average: 7.8 hours

Total staff hours (quarter) 18,577
Nursing staff breakdown
Registered Nurse

Manages medical care and health needs.

Total count 8
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours

This role is partially covered by contractors.

Licensed Practical Nurse

Assists with medical care and medications.

Total count 10
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.4 hours

This role is partially covered by contractors.

Certified Nursing Assistant

Helps with daily care and mobility.

Total count 36
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours

This role is partially covered by contractors.

Contractor staffing

Total hours from contractors

22%

4,095 contractor hours this quarter

Certified Nursing Assistant: 13 Licensed Practical Nurse: 3 Registered Nurse: 2 Medication Aide/Technician: 1 Clinical Nurse Specialist: 1
Staff by category
Certified Nursing Assistant2313367,31591100%8.4
Licensed Practical Nurse73103,57991100%9.4
Registered Nurse6281,7498998%8.4
Medication Aide/Technician5161,6229099%8
Dietitian1015266470%8.2
Physical Therapist1015116066%8.5
Nurse Practitioner1014966268%8
Administrator1014806066%8
Other Dietary Services Staff1014716369%7.5
Physical Therapy Assistant3034616875%6.1
Speech Language Pathologist4044606875%5
Mental Health Service Worker1013964954%8.1
Clinical Nurse Specialist1123136673%4.6
Respiratory Therapy Technician2021974448%4.2
36 Certified Nursing Assistant
% of Days 100%
10 Licensed Practical Nurse
% of Days 100%
8 Registered Nurse
% of Days 98%
6 Medication Aide/Technician
% of Days 99%
1 Dietitian
% of Days 70%
1 Physical Therapist
% of Days 66%
1 Nurse Practitioner
% of Days 68%
1 Administrator
% of Days 66%
1 Other Dietary Services Staff
% of Days 69%
3 Physical Therapy Assistant
% of Days 75%
4 Speech Language Pathologist
% of Days 75%
1 Mental Health Service Worker
% of Days 54%
2 Clinical Nurse Specialist
% of Days 73%
2 Respiratory Therapy Technician
% of Days 48%

Facility Characteristics

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

Total residents 44
Medicare
5
11.4% of residents
Medicaid
31
70.5% of residents
Private pay or other
8
18.2% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

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. 17.6
56% worse than Nebraska average

Nebraska average: 11.3

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 31.9
37% worse than Nebraska average

Nebraska average: 23.3

Long-stay resident measures
Significantly below average Nebraska 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 24.0%
16% worse than Nebraska average

Nebraska average: 20.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 46.0%
108% worse than Nebraska average

Nebraska 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 25.8%
In line with Nebraska average

Nebraska average: 26.9%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 6.7%
49% worse than Nebraska average

Nebraska average: 4.5%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 2.6%
39% better than Nebraska average

Nebraska average: 4.3%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 3.1%
In line with Nebraska average

Nebraska average: 3.1%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 8.6%
58% worse than Nebraska average

Nebraska average: 5.4%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 7.1%
59% worse than Nebraska average

Nebraska average: 4.4%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 28.8%
45% worse than Nebraska average

Nebraska average: 19.8%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 92.7%
In line with Nebraska average

Nebraska average: 93.2%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 92.0%
In line with Nebraska average

Nebraska average: 96.1%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 2.01
12% worse than Nebraska average

Nebraska average: 1.80

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 2.96
52% worse than Nebraska average

Nebraska average: 1.95

Short-stay resident measures
Significantly below average Nebraska avg: 2.2 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 71.6%
11% worse than Nebraska average

Nebraska average: 80.7%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.0%
100% better than Nebraska average

Nebraska average: 2.4%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 62.8%
17% worse than Nebraska average

Nebraska average: 75.9%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 25.9%
24% worse than Nebraska average

Nebraska average: 20.9%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 14.4%
24% worse than Nebraska average

Nebraska average: 11.6%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than Nebraska average

Nebraska average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 27.9%
48% worse than Nebraska average

Nebraska average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 37.0%
27% worse than Nebraska average

Nebraska average: 50.6%

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 (Data as of Jan 2026)

Total fines amount $34K
In line with Nebraska average

Nebraska average: $33K

Number of fines 1 Rank #1 / 46Federal fines — state benchmarkedThis home is ranked 1st out of 46 homes in Nebraska.Shows this facility's CMS fine count alongside the Nebraska average, and where it ranks among all 46 skilled nursing facilities in the state. Fewer fines mean a better rank.
31% fewer fines than Nebraska average

Nebraska average: 1.5

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
100% fewer payment denials than Nebraska average

Nebraska average: 0.7

Fines amount comparison
Fines amount comparison
This facility $34K
Nebraska average $33K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Nov 1, 2023
$34K

Last updated: Jan 2026

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