01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-21 | 11 | 2025-08-21 | 1 |
| Cycle 2 | 2024-03-14 | 4 | 2024-03-14 | 1 |
| Cycle 3 | 2023-03-30 | 2 | 2023-03-30 | 0 |
CMS CCN 4350662026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Avera Prince Of Peace
4513 South Prince Of Peace Place · Sioux Falls, SD 57103 · Minnehaha County
Certified beds126CMS provider file
Recent citation rows19current CMS citation release
Penalty rows1current 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
1 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-11-06 · HEALTHF0627Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Correction field: Deficient, Provider has date of correction · 2026-01-22 · complaint2025-11-06 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-01-22 · complaint2025-08-21 · HEALTHF0565Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0583Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0600Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2025-10-042025-08-21 · 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 · 2025-10-042025-08-21 · HEALTHF0880Severity E · pattern; 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 · 2025-10-042025-08-21 · FIREK0131Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Meet requirements for sections of health care facilities separated by fire resistive construction.
Correction field: Deficient, Provider has date of correction · 2025-09-192025-07-03 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-08-05 · complaint2025-07-03 · HEALTHF0689Severity G · isolated actual 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 · 2025-08-05 · complaint2024-03-14 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-04-282024-03-14 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-04-282024-03-14 · FIREK0321Severity D · isolated; 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 · 2024-03-212023-03-30 · 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 · 2023-05-142023-03-30 · 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 · 2023-04-2803 / 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 |
|---|---|---|---|
| 2025-07-02 | Fine | $8,278 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- AVERA HEALTHOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 06/15/1992
- ABOUREZK, SANAAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2024
- BOSCHEE, RYANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2024
- BUNKERS, JENNIFERIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2021
- CHRYSTAL, CANDYCEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2023
- COSTELLO, JOSEPHIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2017
- CURRAN, MARYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2015
- FISHBACK, VANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2018
- GORDON, JEFFREYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2023
- HILL JENSEN, CRISTINAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2018
- KALLEMEYN, BRENDAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2023
- KIRBY, JENNIFERIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2020
- KNECHT, RANDYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2018
- KNUTSON, LAURIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2017
- NAZIR, JAWADIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2020
- PLACE, RONALDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/05/2023
- REINDL, ALISAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2021
- SEIFERT, ROXANNEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/01/2022
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 hours5.74per resident day
RN hours1.47per resident day
Weekend nurse hours5.32per resident day
Staff turnover25.0%CMS reported field
06 / LOCAL RECORDS
Open the Sioux Falls ledger →Other published facilities nearby
Avantara Norton110 beds · CMS overall —/576 citation rowsBethany Home Sioux Falls52 beds · CMS overall 3/513 citation rowsDow Rummel Village50 beds · CMS overall 3/515 citation rowsGood Samaritan Society Luther Manor92 beds · CMS overall 2/523 citation rowsGood Samaritan Society Sioux Falls Center98 beds · CMS overall 2/525 citation rowsGood Samaritan Society Sioux Falls Village177 beds · CMS overall 2/532 citation rows