Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Avera Sunrise Manor during CMS and state inspections, most recent first.
The facility failed to ensure an RN was on duty for a minimum of 8 consecutive hours a day, 7 days per week, for 2 of the 168 days reviewed. The DON confirmed limited RN staff, and the facility occasionally used an RN from the adjoining hospital who was not physically present. Recruitment efforts have been unsuccessful, and no policy for RN coverage was provided by the end of the survey.
The facility failed to ensure that a resident's physician acted upon pharmacy recommendations for several months, despite the resident having multiple diagnoses and the pharmacist making repeated recommendations for medication adjustments and documentation. The DON and MD confirmed the issue, and the consulting pharmacist noted the lack of response from the physician.
The facility failed to ensure that PRN psychoactive medications for a resident were not given without a rationale for continued use and an indicated specific duration. Despite frequent use of lorazepam and trazodone, the required documentation was not provided, and the facility did not act on repeated pharmacy recommendations.
Failure to Ensure RN Coverage for 8 Consecutive Hours Daily
Penalty
Summary
The facility failed to ensure a registered nurse (RN) was on duty for a minimum of 8 consecutive hours a day, 7 days per week, for 2 of the 168 days reviewed. Specifically, there was no RN coverage on 12/10/23 and 3/3/24. The director of nursing (DON) confirmed that the facility only has one full-time RN other than herself and the case manager. At times, the facility used an RN from the adjoining hospital for coverage, but this RN was not physically present in the facility and only took calls. The administrator acknowledged the issue and mentioned efforts to recruit more RNs, including offering sign-on and recruitment bonuses and advertising on various platforms. However, these efforts have not yet yielded results. No facility policy for RN coverage was provided by the end of the survey.
Failure to Act on Pharmacy Recommendations
Penalty
Summary
The facility failed to ensure that the contracted pharmacist, in conjunction with the facility, had a method to ensure resident's physicians acted upon pharmacy recommendations. This deficiency was identified for one resident (R21) who had multiple diagnoses including anemia, generalized anxiety disorder, major depressive disorder, chronic colitis, COPD with asthma, restless leg syndrome, high blood pressure, acute and chronic respiratory failure with hypoxia, diabetes mellitus type 2, low thyroid disorder, insomnia, back pain, and arthritis. Despite the pharmacist's recommendations for gradual dose reduction (GDR) of antipsychotic medication and documentation of rationale for continued use of PRN psychoactive medications, there was no evidence that the physician acted on these recommendations over several months. The pharmacist's recommendations were made in December 2023, February 2024, and March 2024, but the physician did not respond to these recommendations, and the necessary documentation was not completed. The Director of Nursing (DON) confirmed that the physician had not acted on the pharmacist's recommendations for the last three months, and the Medical Director (MD) acknowledged that this was an ongoing issue that the facility was actively working to address. The consulting pharmacist also confirmed that the physician had not responded to the recommendations and that this was causing stress for the facility. The facility's policy required collaboration between providers, facility staff, and the pharmacist to meet resident needs, but this collaboration was not effectively implemented in this case.
Failure to Document Rationale and Duration for PRN Psychoactive Medications
Penalty
Summary
The facility failed to ensure that as-needed (PRN) psychoactive medications were not given without a rationale for continued use and an indicated specific duration for one resident (R21). R21 had multiple diagnoses, including generalized anxiety disorder, major depressive disorder, and insomnia, and was prescribed lorazepam 0.5 mg four times a day PRN for anxiety and trazodone 50 mg at bedtime PRN for insomnia. These medications were used frequently over several months without the required documentation of rationale and duration for continued use beyond 14 days. The facility's pharmacist had reminded the medical provider of the need for this documentation, but the provider did not act on these recommendations, and the medications continued to be administered without the necessary documentation. Interviews with the Director of Nursing (DON), Medical Director (MD), and Consulting Pharmacist revealed that the facility was aware of the issue but had not taken appropriate action to address it. The DON was unaware that the PRN orders had not been renewed every 14 days, and the MD acknowledged that pharmacy recommendations should be addressed timely. The Consulting Pharmacist confirmed that the recommendations had been repeatedly sent to the provider without response. The facility's policy for PRN psychoactive medications was requested but not provided, and the existing policy for antipsychotic medications did not address other psychoactive PRN medications.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 7 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Tyler
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Good Samaritan Society - Pipestone | 19.6 mi | ★★★★★ | 1 | 1 |
| Avera Morningside Heights Care Center | 21.3 mi | ★★★★★ | 6 | 1 |
| Hendricks Community Hospital | 21.5 mi | ★★★★★ | 0 | 0 |
| Prairie View Senior Living | 26.1 mi | ★★★★★ | 6 | 0 |
| Edgebrook Care Center | 27.3 mi | ★★★★★ | 12 | 1 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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 July 2026) and official state health department websites.