01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-12 | 5 | 2026-03-12 | 1 |
| Cycle 2 | 2025-03-20 | 5 | 2025-03-20 | 3 |
| Cycle 3 | 2024-05-30 | 2 | 2024-05-30 | 3 |
CMS CCN 1654742026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
The Ambassador Sidney Inc
115 Main Street · Sidney, IA 51652 · Fremont County
Certified beds46CMS provider file
Recent citation rows19current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
19 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-12 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Past Non-Compliance · 2026-01-012026-03-12 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2026-04-072026-03-12 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-04-072026-03-12 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2026-04-072026-03-12 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-04-072026-03-12 · FIREK0321Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2026-04-032025-03-20 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-20 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-20 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-20 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-20 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-04-162025-03-20 · FIREK0293Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2025-03-252025-03-20 · FIREK0511Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-03-172025-03-20 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-03-172024-05-30 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-06-252024-05-30 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2024-06-252024-05-30 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-06-042024-05-30 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-06-042024-05-30 · FIREK0923Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2024-06-0403 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- FIRST NATIONAL BANK OMAHAOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 01/30/2018
- JUILFS, SALLYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/05/1985
- JUILFS, TIMOTHYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2004
- JUILFS, TYLERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- JUILFS, SALLYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/05/1985
- JUILFS, TIMOTHYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/05/1985
- JUILFS, TYLERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2021
- THE AMBASSADOR GROUP INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/09/1981
- HARRAH, JADEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/10/2022
- LONG, DORAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/16/2021
- OURADA, MICHAELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- SHANHOLTZ, BRENTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2013
- AMBASSADOR HOLDING COMPANYOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/05/1985
- FIRST NATIONAL BANK OMAHAOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/16/2025
- THE AMBASSADOR GROUP INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/09/1981
- HARRAH, JADEIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/30/2025
- JUILFS, SALLYIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/05/1985
- JUILFS, TIMOTHYIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/05/1985
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.54per resident day
RN hours0.51per resident day
Weekend nurse hours3.08per resident day
Staff turnover34.1%CMS reported field
06 / LOCAL RECORDS
Open the Iowa ledger →Other published facilities nearby
No second facility in the same city met the directory rule.