Clay County, South Dakota · Nursing home
Sunset Manor Avera Health
2 of 5 overall from CMS
129 E Clay St, Irene, SD 57037
At a glance
- Overall rating 2 of 5 Below the state average of 2.9
- Nurse time per resident, per day 5.10 hours Above the state average of 3.79
- Nursing staff who left in a year 70.4% Above the state average of 48.2%
- Health citations, last 3 inspection cycles 17 4 at the harm level or above
- Fines in 3 years $56,946 3 fines
- Certified beds in use 85.7% of 58 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Sunset Manor Avera Health is a 58-bed nursing home in Irene, South Dakota (Clay County). CMS rates it 2 of 5 stars overall as of Sep 2026. It reports 5.10 nurse staffing hours per resident per day, above the South Dakota average of 3.79. CMS lists 3 fines totaling $56,946 in the past three years.
- Certified beds
- 58
- Residents per day (average)
- 49.7
- Certified since
- 1997 (29 yrs)
Non profit - Other Participates in Medicare and MedicaidPart of Avera Health (13 homes)CMS abuse citation icon: Yes
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
- Abuse citation icon. CMS assigns this icon when a home was cited for abuse where residents were found to be harmed, on its most recent standard inspection or on a complaint or infection-control inspection in the past 12 months, or was cited for abuse with potential harm in that period and again in the period before. Signs of abuse and how to report it
These labels are shown as CMS publishes them. They describe the inspection record, not what has changed since.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Sunset Manor Avera Health
Chosen from this home's public data.
- CMS lists 3 fines totaling $56,946 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 7 health deficiencies in the latest inspection cycle (the standard inspection on Dec 31, 2025 plus complaint and infection-control inspections); the South Dakota average is 6.7. Which have been corrected?Inspection results in CMS data
- Nursing staff turnover is 70.4%, above the South Dakota average of 48.2%. How often would the same aides care for my relative?Turnover in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 2 of 5 South Dakota average 2.9
- Health inspections 2 of 5 South Dakota average 2.9
- Staffing 4 of 5 South Dakota average 3.5
- Quality measures 2 of 5 South Dakota average 2.7
The vertical line marks the South Dakota average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 5.10 h South Dakota average 3.79
- Nurse aides 3.69 h South Dakota average 2.52
- Licensed practical nurses 0.56 h South Dakota average 0.47
- Registered nurses 0.85 h South Dakota average 0.80
- All staff, weekends 4.27 h South Dakota average 3.26
How much nurse staffing is enough? All bars share one scale, 0 to 9 hours. The vertical line marks the South Dakota average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover70.4%
- South Dakota average48.2%
- Registered nurse turnover72.7%
- South Dakota average34.7%
- Administrators who left0
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the South Dakota and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | South Dakota | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 31.3% | 21.3% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 3.6% | 5.6% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.4% | 2.1% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.5% | 2.9% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 17.7% | 5.7% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.5% | 0.0% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 6.1% | 5.5% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.5% | 94.9% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 23.2% | 19.4% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 39.0% | 17.4% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% | 96.9% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 3.4% | 4.6% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 20.7% | 25.4% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 74.0% | 24.6% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 1.74 | 1.52 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 0.72 | 1.75 | 1.78 |
Short-stay residents
| Measure | This home | South Dakota | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Too few residents or stays to report | 83.5% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | Too few residents or stays to report | 2.0% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Too few residents or stays to report | 78.2% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | Too few residents or stays to report | 19.9% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | Too few residents or stays to report | 12.0% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 17 health deficiencies in the three most recent inspection cycles. Of these, 4 involved actual harm; the rest were graded as no actual harm. 12 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on May 5, 2026: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Dec 31, 2025 | 7 | 5 |
| Aug 8, 2024 | 7 | 3 |
| Jul 13, 2023 | 3 | 5 |
South Dakota homes averaged 6.7 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (17)
-
GActual harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Jun 3, 2026)
-
DPotential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Jun 3, 2026)
-
FPotential for more than minimal harm, widespread
Post nurse staffing information every day.
Nursing and Physician Services · Deficient, Provider has date of correction (Jan 8, 2026)
-
EPotential for more than minimal harm, pattern
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Feb 4, 2026)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Jan 16, 2026)
Show 12 more
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Feb 4, 2026)
-
DPotential for more than minimal harm, isolated
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Feb 4, 2026)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Jul 16, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Jul 16, 2025)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Jul 22, 2025)
-
GActual harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Mar 13, 2025)
-
EPotential for more than minimal harm, pattern
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Mar 13, 2025)
-
HActual harm, pattern
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Oct 23, 2024)
-
HActual harm, pattern
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Oct 23, 2024)
-
EPotential for more than minimal harm, pattern
Ensure each resident receives an accurate assessment.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 6, 2024)
-
DPotential for more than minimal harm, isolated
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Sep 22, 2024)
-
DPotential for more than minimal harm, isolated
Assure that each resident’s assessment is updated at least once every 3 months.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Aug 25, 2023)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| May 5, 2026 | Fine | $16,350 |
| Feb 12, 2025 | Fine | $11,190 |
| Sep 25, 2024 | Fine | $29,406 |
South Dakota homes averaged 1.9 fines and $40,815 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within South Dakota
- Size38 of 96 by certified beds
- South Dakota average residents per day52.1
- ChainAvera Health
- Chain average overall rating3.8 of 5
- Resident or family councilResident
- Homes in Clay County3
Common questions
What is the CMS star rating for Sunset Manor Avera Health?
Sunset Manor Avera Health has an overall rating of 2 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 2, staffing is 4 and quality measures is 2.
How many beds does Sunset Manor Avera Health have?
Sunset Manor Avera Health has 58 certified beds. It averages 49.7 residents per day, about 85.7% of its certified beds.
How much nursing care do residents get at Sunset Manor Avera Health?
The home reports 5.10 hours of nurse staffing per resident per day, including 0.85 hours from registered nurses. The South Dakota average is 3.79 hours and 0.80 hours from registered nurses.
Has Sunset Manor Avera Health been fined?
Yes. CMS lists 3 fines totaling $56,946 in the past three years.
Does Sunset Manor Avera Health accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 5 of 5 Wakonda Heritage Manor 38beds 95.3%in use 3.85nurse hours a day
- 5 of 5 Pioneer Memorial Nursing Home 46beds 90.7%in use 3.91nurse hours a day
- 1 of 5 Centerville Care and Rehab Center Inc 42beds 87.4%in use 3.31nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Clay County
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 435100. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.