Not rated by CMS — ratings are suppressed for new or low-volume facilities.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Avera Sister James Care Center during CMS and state inspections, most recent first.
Staff failed to follow a high fall-risk resident’s care plan and facility policy requiring use of a gait belt during assisted ambulation. The cognitively intact resident, with CHF, weakness, hyponatremia, and multiple documented high fall-risk assessments, was care planned and discharged from therapy for one-person contact guard assist with a walker and gait belt, including during a walk-to-dine program. While being walked to the dining room by a CMA who knew the resident required one-person assist, no gait belt was used; the resident walked too fast, his walker moved too far ahead, he tripped over his feet, fell forward into a table, and sustained a nasal bone fracture and multiple skin tears, requiring ER evaluation.
The facility failed to enforce its tobacco-free campus policy, allowing three residents to smoke on the property. Observations showed residents smoking outside exit doors and keeping smoking supplies in their rooms. Staff interviews confirmed noncompliance with the policy, despite residents being assessed as safe to smoke independently. The facility's policy prohibited smoking on campus, but residents were still permitted to smoke outside.
Two residents were allowed to self-administer medications without proper assessments or physician's orders. One resident used a nasal spray for a dry nose caused by oxygen use, while another used a nebulizer for breathing treatments. The facility's policy requiring assessments and orders was not followed.
Failure to Use Required Gait Belt During Assisted Ambulation Resulting in Fall With Injury
Penalty
Summary
Staff failed to follow an identified fall-risk resident’s care plan and facility policy requiring use of a gait belt during assisted ambulation, resulting in a fall with injury. The resident, who was cognitively intact with a BIMS score of 15, had diagnoses including CHF, weakness, and hyponatremia, and had been assessed multiple times as being at high risk for falls. His care plan and therapy discharge instructions specified that he required one-person assist with ambulation using a walker and a gait belt, and he was on a walk-to-dine program in which staff were to walk with him to and from meals. The care plan interventions included use of a walker with a gait belt and one assist, wheelchair with foot pedals for distance, and cues to slow down when ambulating. On the day of the incident, the resident was ambulating to the dining room with a certified medication aide who knew he required one-person assist with ambulation but did not apply a gait belt. As they walked, the resident began walking too fast, his walker moved too far in front of him, and despite the aide cueing him to slow down, he tripped over his own feet, fell forward into a table, hit his head, and landed on the floor. He sustained a nasal bone fracture and multiple skin tears on his face and arms and required evaluation in the emergency room. Subsequent observations showed multiple cuts and bruises on his face and arms, and interviews with staff and therapy confirmed that a gait belt should have been used whenever he was assisted with walking, in accordance with his care plan and the facility’s gait belt and falls/accident policies.
Failure to Enforce Tobacco-Free Campus Policy
Penalty
Summary
The provider failed to implement their tobacco-free campus policy for three residents who smoked on the property. Observations revealed that Resident 144 was seen smoking outside the side exit door, which had been propped open, while a staff member monitored her. Resident 66 was found to keep smoking supplies in his room and was allowed by staff to smoke outside when he wished. Resident 115 was observed smoking on the facility property and discarding her cigarette in the landscaping. Interviews with staff confirmed that residents were smoking on campus despite the tobacco-free policy, and that the Director of Nursing (DON) was planning to inform residents of a smoking ban. The residents involved were cognitively intact, as indicated by their Brief Interview of Mental Status (BIMS) scores of 15. They had various medical conditions, including bipolar disorder, chronic kidney disease, and diabetes. Smoking assessments had been completed for these residents, determining them safe to smoke independently. The facility's policy, as outlined in their welcome booklet and Tobacco-Free Campus Policy, clearly stated that smoking was not permitted on the campus by anyone, and tobacco waste should not be left on the property. Despite this, the facility allowed residents to smoke outside exit doors, and smoking supplies were kept in residents' rooms or at the nurses' station.
Failure to Assess and Obtain Orders for Self-Administration of Medications
Penalty
Summary
The facility failed to ensure that two residents, identified as 80 and 330, were assessed for their ability to safely self-administer medications and did not obtain the necessary physician's orders for self-administration. Resident 330 was observed with a prescription nasal spray at his bedside, which he used daily for a dry nose caused by oxygen use. Despite a request for a physician's order for the nasal spray, there was no documented assessment or order for the resident to self-administer the medication or to keep it at his bedside. The RN supervisor was unaware of the resident's self-administration and acknowledged the lack of a completed assessment. Similarly, resident 80 was observed using a nebulizer machine for breathing treatments without a physician's order for self-administration. The resident's electronic medical records indicated scheduled nebulizer treatments, but there was no documentation of an assessment or order for self-administration. An RN confirmed that it was her practice to allow the resident to self-administer the treatment, but she was unaware if an assessment had been completed. The facility's policy requires an interdisciplinary team assessment and a physician's order for self-administration, which were not followed in these cases.
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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.
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Nursing homes near Yankton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Sd Human Services Center - Geriatric Program | 2.8 mi | — | 0 | 0 |
| Wakonda Heritage Manor | 18.6 mi | — | 0 | 0 |
| Sunset Manor Avera Health | 19.6 mi | — | 10 | 0 |
| Accura Healthcare Of Hartington | 19.7 mi | — | 5 | 0 |
| Good Samaritan Society - Bloomfield | 22.4 mi | — | 8 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.