nursing home in Milbank, SD
Avantara Milbank
1103 South Second Street, Milbank, SD 57252 · (605) 432-4556
★★★★★1
Much below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★1
- Staffing★★★★★2
- Quality measures★★★★★2
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
Avantara Milbank at a glance
Avantara Milbank is a 55-bed for-profit nursing home in Milbank, South Dakota (Grant County).
CMS gives it 1 out of 5 stars on its overall star rating, worse than the South Dakota average of 2.9.
Residents receive about 3.2 hours of nursing care per day (1 of them from registered nurses), worse than the state average of 3.8 hours.
Its most recent standard health inspection (July 9, 2026) found 13 health citations. The South Dakota average is 6.7.
Federal regulators fined it 4 times in the past three years, totaling $125,981.
Nursing staff turnover is 91.5% per year (state average 48.2%).
Facility details
- Type
- Nursing home
- Ownership
- For Profit - Limited Liability Company
- Beds
- 55
- Certified for
- Medicare and Medicaid
- Chain / affiliated entity
- Legacy Healthcare
- Medicare-certified since
- February 1, 1967
- Resident/family council
- Resident
- County
- Grant County
- CMS Certification Number
- 435009
Ratings
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Overall star rating ⓘ (higher is better) | 1 / 5 | 2.9 / 5 | 3 / 5 | Worse |
| Health inspection rating ⓘ (higher is better) | 1 / 5 | 2.9 / 5 | 2.8 / 5 | Worse |
| Staffing rating ⓘ (higher is better) | 2 / 5 | 3.5 / 5 | 2.9 / 5 | Worse |
| Quality measures rating ⓘ (higher is better) | 2 / 5 | 2.7 / 5 | 3.6 / 5 | Worse |
| Long-stay quality rating (higher is better) | 2 / 5 | 2.6 / 5 | 3.8 / 5 | Worse |
Staffing
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 3.23 hrs | 3.79 hrs | 3.86 hrs | Worse |
| Registered nurse hours per resident per day (higher is better) | 0.96 hrs | 0.80 hrs | 0.69 hrs | Better |
| Nurse aide hours per resident per day (higher is better) | 1.85 hrs | 2.52 hrs | 2.32 hrs | Worse |
| Weekend nurse staff hours per resident per day (higher is better) | 2.94 hrs | 3.26 hrs | 3.42 hrs | Worse |
| Nursing staff turnover (yearly) (lower is better) | 91.5% | 48.2% | 45.8% | Worse |
| Registered nurse turnover (yearly) (lower is better) | 86.7% | 34.7% | 42.9% | Worse |
| Administrators who left in the past year (lower is better) | 2 | 0 | 1 | Worse |
Inspections
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Health citations in the most recent inspection (lower is better) | 13 | 7 | 9 | Worse |
| Citations from complaint investigations (latest cycle) (lower is better) | 12 | 2 | 3 | Worse |
| Weighted health inspection score ⓘ (lower is better) | 121 | 72.2 | 80.6 | Worse |
Penalties
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Fines in the past 3 years (lower is better) | 4 | 2 | 1 | Worse |
| Total fines in the past 3 years (lower is better) | $125,981 | $40,815 | $30,972 | Worse |
| All federal penalties in the past 3 years (lower is better) | 4 | 2 | 1 | Worse |
Size
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 55 | 61 | 107 | |
| Average residents per day | 38 | 52 | 86 | |
| Occupancy | 69.1% | 85.2% | 80.9% |
Long-stay residents
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Long-stay residents with a fall causing major injury (lower is better) | 1.5% | 5.5% | 3.2% | Better |
| Long-stay residents with pressure ulcers (lower is better) | 10.1% | 4.6% | 4.6% | Worse |
| Long-stay residents given antipsychotic medication (lower is better) | 26.6% | 24.6% | 15.4% | Worse |
| Long-stay residents with a urinary tract infection (lower is better) | 3.1% | 2.9% | 1.6% | Worse |
| Long-stay residents with a catheter left in the bladder (lower is better) | 3.4% | 2.1% | 0.8% | Worse |
| Long-stay residents needing more help with daily activities (lower is better) | 31.6% | 21.3% | 13.9% | Worse |
| Long-stay residents whose walking worsened (lower is better) | 23.2% | 19.4% | 14.1% | Worse |
| Long-stay residents who lose too much weight (lower is better) | 8.5% | 5.6% | 5.2% | Worse |
| Long-stay residents with depressive symptoms (lower is better) | 28.1% | 5.7% | 12.8% | Worse |
| Long-stay residents who were physically restrained (lower is better) | 0% | 0% | 0.1% | Better |
| Long-stay residents given anti-anxiety or sleep medication (lower is better) | 28.7% | 17.4% | 19.5% | Worse |
| Long-stay residents with new or worse incontinence (lower is better) | 24.1% | 25.4% | 19% | Worse |
| Long-stay residents given a flu vaccine (higher is better) | 97.3% | 96.9% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 82.4% | 94.9% | 93.6% | Worse |
Short-stay residents
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Short-stay residents newly given antipsychotic medication (lower is better) | 5.4% | 2% | 1.6% | Worse |
| Short-stay residents given a pneumonia vaccine (higher is better) | 62% | 83.5% | 82% | Worse |
Inspection citations
State inspectors cited this home for 30 health deficiencies and 9 fire safety deficiencies in the inspection records CMS currently publishes. 8 citations involved actual harm.
| Date | Citation | Severity | Status |
|---|---|---|---|
| July 9, 2026 Fire safety | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Tag K0353 | F Potential harm, widespread | Corrected August 23, 2026 |
| July 9, 2026 Fire safety | Meet requirements for the installation and maintenance of electrical systems. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0911 | D Potential harm, isolated | Corrected August 23, 2026 |
| July 9, 2026 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | F Potential harm, widespread | Corrected August 23, 2026 |
| May 7, 2026 Complaint | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | G Actual harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. Quality of Life and Care Deficiencies · Tag F0740 | G Actual harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Tag F0684 | E Potential harm, pattern | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | E Potential harm, pattern | Corrected June 6, 2026 |
| May 7, 2026 Complaint | 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. Pharmacy Service Deficiencies · Tag F0761 | E Potential harm, pattern | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | E Potential harm, pattern | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0602 | E Potential harm, pattern | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Tag F0658 | D Potential harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | D Potential harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. Quality of Life and Care Deficiencies · Tag F0693 | D Potential harm, isolated | Corrected June 6, 2026 |
| May 7, 2026 Complaint | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Tag F0657 | D Potential harm, isolated | Corrected June 6, 2026 |
| March 13, 2025 Fire safety | Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Tag K0211 | E Potential harm, pattern | Corrected June 19, 2025 |
| March 13, 2025 Fire safety | Install an approved automatic sprinkler system. Smoke Deficiencies · Tag K0351 | D Potential harm, isolated | Corrected March 18, 2025 |
| March 13, 2025 Fire safety | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Tag K0741 | D Potential harm, isolated | Corrected March 24, 2025 |
| March 13, 2025 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | D Potential harm, isolated | Corrected April 18, 2025 |
| March 13, 2025 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | F Potential harm, widespread | Corrected April 21, 2025 |
| March 13, 2025 Standard | Honor each resident's preferences, choices, values and beliefs. Quality of Life and Care Deficiencies · Tag F0675 | E Potential harm, pattern | Corrected April 21, 2025 |
| March 13, 2025 Complaint | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | E Potential harm, pattern | Corrected April 21, 2025 |
| March 13, 2025 Standard | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · Tag F0623 | D Potential harm, isolated | Corrected April 21, 2025 |
| March 13, 2025 Standard | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · Tag F0625 | D Potential harm, isolated | Corrected April 21, 2025 |
| December 18, 2024 Complaint | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | G Actual harm, isolated | Corrected January 17, 2025 |
| December 18, 2024 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | D Potential harm, isolated | Corrected January 17, 2025 |
| December 18, 2024 Complaint | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · Tag F0585 | D Potential harm, isolated | Corrected January 17, 2025 |
| October 8, 2024 Complaint | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · Tag F0692 | G Actual harm, isolated | Corrected November 2, 2024 |
| October 8, 2024 Complaint | Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 | G Actual harm, isolated | Corrected November 2, 2024 |
| October 8, 2024 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | G Actual harm, isolated | Corrected November 2, 2024 |
| August 6, 2024 Complaint | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Tag F0677 | E Potential harm, pattern | Corrected September 10, 2024 |
| November 8, 2023 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | F Potential harm, widespread | Corrected December 4, 2023 |
| November 8, 2023 Fire safety | Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Tag K0211 | D Potential harm, isolated | Corrected November 24, 2023 |
| November 8, 2023 Fire safety | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Tag K0363 | C No harm, widespread | Corrected November 24, 2023 |
| November 8, 2023 Standard | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Tag F0658 | G Actual harm, isolated | Corrected December 6, 2023 |
| November 8, 2023 Standard | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | G Actual harm, isolated | Corrected December 6, 2023 |
| November 8, 2023 Standard | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | E Potential harm, pattern | Corrected December 6, 2023 |
| November 8, 2023 Standard | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Tag F0656 | D Potential harm, isolated | Corrected December 6, 2023 |
| November 8, 2023 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected December 6, 2023 |
Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; J–L immediate jeopardy to resident health or safety. How to read inspection citations.
Fines and payment denials
CMS reports 4 federal penalties in the past three years, including $125,981 in fines.
| Date | Penalty | Amount / length |
|---|---|---|
| May 7, 2026 | Fine | $70,620 |
| December 18, 2024 | Fine | $28,912 |
| October 8, 2024 | Fine | $15,041 |
| November 8, 2023 | Fine | $11,408 |
Owners and managers
Individuals and organizations reported to CMS as owning or operating this nursing home.
| Name | Role | Share | Since |
|---|---|---|---|
| DOROS GENERATION TRUST U/A/D 1/3/12 Organization | 5% or greater direct ownership interest | 43% | 07/01/2019 |
| GPN FAMILY TRUST U/A/D 4/28/08 Organization | 5% or greater direct ownership interest | 43% | 07/01/2019 |
| OAKWAY OPERATIONS LLC Organization | 5% or greater direct ownership interest | 15% | 07/01/2019 |
| MILBANK SD PROPERTY HOLDINGS, LLC Organization | 5% or greater security interest | NOT APPLICABLE | 07/01/2019 |
| TRUIST BANK Organization | 5% or greater security interest | NOT APPLICABLE | 04/01/2022 |
| DOROS GENERATION TRUST U/A/D 1/3/12 Organization | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| EGGERS, AUSTIN Individual | adp of the snf | NOT APPLICABLE | 01/01/2025 |
| GPN FAMILY TRUST U/A/D 4/28/08 Organization | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| LEGACY HEALTHCARE FINANCIAL SERVICES LLC Organization | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| MILBANK SD PROPERTY HOLDINGS, LLC Organization | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| PULSE, REBECCA Individual | adp of the snf | NOT APPLICABLE | 01/02/2024 |
| RAJCHENBACH, CHAIM Individual | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| RSM US LLP Organization | adp of the snf | NOT APPLICABLE | 01/01/2024 |
| SHABAT, MENACHEM Individual | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| RAJCHENBACH, CHAIM Individual | managing control - governing body | NOT APPLICABLE | 07/01/2019 |
| SHABAT, MENACHEM Individual | managing control - governing body | NOT APPLICABLE | 07/01/2019 |
| EGGERS, AUSTIN Individual | operational/managerial control | NOT APPLICABLE | 01/01/2025 |
| PULSE, REBECCA Individual | operational/managerial control | NOT APPLICABLE | 01/02/2024 |
| RAJCHENBACH, CHAIM Individual | operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| SHABAT, MENACHEM Individual | operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| TRUIST BANK Organization | operational/managerial control | NOT APPLICABLE | 04/01/2022 |
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Frequently asked questions
What is Avantara Milbank's rating?
Avantara Milbank has 1 out of 5 stars on the CMS overall star rating. The average for South Dakota nursing homes is 2.9 stars.
How many inspection citations did Avantara Milbank receive?
Its most recent standard health inspection found 13 citations, compared with a South Dakota average of 6.7. Every citation is listed on this page with its severity.
Does Avantara Milbank accept Medicare and Medicaid?
CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.
Who owns Avantara Milbank?
It is for profit - limited liability company and part of Legacy Healthcare. The ownership section on this page lists the owners and managers reported to CMS.
Where is Avantara Milbank and how do I contact it?
Avantara Milbank is at 1103 South Second Street, Milbank, SD 57252. Phone: (605) 432-4556.
About this data
Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.