nursing home in Watertown, SD
Avantara Watertown
415 Fourth Ave NE, Watertown, SD 57201 · (605) 886-8431
★★★★★1
Much below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★1
- Staffing★★★★★3
- Quality measures★★★★★2
- Special Focus candidate
- Abuse citation
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
Avantara Watertown at a glance
Avantara Watertown is a 51-bed for-profit nursing home in Watertown, South Dakota (Codington 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 3.6 hours of nursing care per day (1.1 of them from registered nurses), worse than the state average of 3.8 hours.
Its most recent standard health inspection (April 29, 2026) found 26 health citations. The South Dakota average is 6.7.
Federal regulators fined it 3 times in the past three years, totaling $71,591.
Nursing staff turnover is 44.2% per year (state average 48.2%).
Facility details
- Type
- Nursing home
- Ownership
- For Profit - Limited Liability Company
- Beds
- 51
- Certified for
- Medicare and Medicaid
- Chain / affiliated entity
- Legacy Healthcare
- Medicare-certified since
- March 1, 1993
- Resident/family council
- Resident
- County
- Codington County
- CMS Certification Number
- 435068
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) | 3 / 5 | 3.5 / 5 | 2.9 / 5 | Average |
| 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 |
| Short-stay (rehab) quality rating (higher is better) | 3 / 5 | 3.3 / 5 | 3.3 / 5 | Average |
Staffing
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 3.57 hrs | 3.79 hrs | 3.86 hrs | Worse |
| Registered nurse hours per resident per day (higher is better) | 1.06 hrs | 0.80 hrs | 0.69 hrs | Better |
| Nurse aide hours per resident per day (higher is better) | 2.09 hrs | 2.52 hrs | 2.32 hrs | Worse |
| Weekend nurse staff hours per resident per day (higher is better) | 2.87 hrs | 3.26 hrs | 3.42 hrs | Worse |
| Nursing staff turnover (yearly) (lower is better) | 44.2% | 48.2% | 45.8% | Average |
| Registered nurse turnover (yearly) (lower is better) | 27.3% | 34.7% | 42.9% | Better |
| Administrators who left in the past year (lower is better) | 1 | 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) | 26 | 7 | 9 | Worse |
| Citations from complaint investigations (latest cycle) (lower is better) | 8 | 2 | 3 | Worse |
| Weighted health inspection score ⓘ (lower is better) | 307 | 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) | 3 | 2 | 1 | Worse |
| Total fines in the past 3 years (lower is better) | $71,591 | $40,815 | $30,972 | Worse |
| All federal penalties in the past 3 years (lower is better) | 3 | 2 | 1 | Worse |
Size
| Measure | This facility | South Dakota avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 51 | 61 | 107 | |
| Average residents per day | 47 | 52 | 86 | |
| Occupancy | 91.4% | 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) | 2.5% | 5.5% | 3.2% | Better |
| Long-stay residents with pressure ulcers (lower is better) | 7.5% | 4.6% | 4.6% | Worse |
| Long-stay residents given antipsychotic medication (lower is better) | 15.3% | 24.6% | 15.4% | Average |
| Long-stay residents with a urinary tract infection (lower is better) | 5.9% | 2.9% | 1.6% | Worse |
| Long-stay residents with a catheter left in the bladder (lower is better) | 1.7% | 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) | 23.9% | 19.4% | 14.1% | Worse |
| Long-stay residents who lose too much weight (lower is better) | 10.5% | 5.6% | 5.2% | Worse |
| Long-stay residents with depressive symptoms (lower is better) | 14% | 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) | 15% | 17.4% | 19.5% | Better |
| Long-stay residents with new or worse incontinence (lower is better) | 28.7% | 25.4% | 19% | Worse |
| Long-stay residents given a flu vaccine (higher is better) | 94.9% | 96.9% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 86% | 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) | 0% | 2% | 1.6% | Better |
| Short-stay residents given a flu vaccine (higher is better) | 42.9% | 78.2% | 79.8% | Worse |
| Short-stay residents given a pneumonia vaccine (higher is better) | 65.7% | 83.5% | 82% | Worse |
Inspection citations
State inspectors cited this home for 32 health deficiencies and 8 fire safety deficiencies in the inspection records CMS currently publishes. 4 citations involved actual harm, including 2 rated "immediate jeopardy".
| Date | Citation | Severity | Status |
|---|---|---|---|
| June 17, 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 July 15, 2026 |
| April 29, 2026 Fire safety | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Tag K0291 | D Potential harm, isolated | Corrected May 11, 2026 |
| April 29, 2026 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | D Potential harm, isolated | Corrected May 5, 2026 |
| April 29, 2026 Fire safety | Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Egress Deficiencies · Tag K0222 | D Potential harm, isolated | Corrected May 5, 2026 |
| April 29, 2026 Fire safety | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. Egress Deficiencies · Tag K0223 | C No harm, widespread | Corrected May 5, 2026 |
| April 29, 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 | K Immediate jeopardy, pattern | Corrected June 2, 2026 |
| April 29, 2026 Standard | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 | J Immediate jeopardy, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | G Actual harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. Administration Deficiencies · Tag F0837 | F Potential harm, widespread | Corrected June 2, 2026 |
| April 29, 2026 Standard | Have a plan that describes the process for conducting QAPI and QAA activities. Administration Deficiencies · Tag F0865 | F Potential harm, widespread | Corrected June 2, 2026 |
| April 29, 2026 Standard | Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · Tag F0583 | F Potential harm, widespread | Corrected June 2, 2026 |
| April 29, 2026 Complaint | Administer the facility in a manner that enables it to use its resources effectively and efficiently. Administration Deficiencies · Tag F0835 | F Potential harm, widespread | Corrected June 2, 2026 |
| April 29, 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 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 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 2, 2026 |
| April 29, 2026 Complaint | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Tag F0655 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 2026 Standard | 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 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 2026 Standard | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. Quality of Life and Care Deficiencies · Tag F0700 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 2026 Standard | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Tag F0695 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 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 | E Potential harm, pattern | Corrected June 2, 2026 |
| April 29, 2026 Standard | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0605 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Tag F0552 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · Tag F0554 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Resident Rights Deficiencies · Tag F0628 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · Tag F0644 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | 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 2, 2026 |
| April 29, 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 2, 2026 |
| April 29, 2026 Standard | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Tag F0759 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | 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 | D Potential harm, isolated | Corrected June 2, 2026 |
| April 29, 2026 Standard | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · Tag F0806 | D Potential harm, isolated | Corrected June 2, 2026 |
| March 6, 2025 Complaint | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | G Actual harm, isolated | Corrected February 28, 2025 |
| December 5, 2024 Fire safety | Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Tag K0211 | F Potential harm, widespread | Corrected January 6, 2025 |
| December 5, 2024 Fire safety | Provide properly sized and located linen or trash receptacles. Miscellaneous Deficiencies · Tag K0754 | E Potential harm, pattern | Corrected January 6, 2025 |
| December 5, 2024 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 January 6, 2025 |
| December 5, 2024 Standard | 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 January 6, 2025 |
| December 5, 2024 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 | E Potential harm, pattern | Corrected January 6, 2025 |
| March 19, 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 April 24, 2024 |
| September 28, 2023 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | D Potential harm, isolated | Corrected October 17, 2023 |
| September 28, 2023 Fire safety | Meet requirements for sections of health care facilities separated by fire resistive construction. Construction Deficiencies · Tag K0131 | D Potential harm, isolated | Corrected October 25, 2023 |
| September 28, 2023 Standard | 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 November 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 3 federal penalties in the past three years, including $71,591 in fines.
| Date | Penalty | Amount / length |
|---|---|---|
| April 29, 2026 | Fine | $37,845 |
| April 29, 2026 | Fine | $27,378 |
| March 6, 2025 | Fine | $6,368 |
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 |
| TRUIST BANK Organization | 5% or greater security interest | NOT APPLICABLE | 04/01/2022 |
| WATERTOWN SD PROPERTY HOLDINGS, LLC Organization | 5% or greater security interest | NOT APPLICABLE | 07/01/2019 |
| DOROS GENERATION TRUST U/A/D 1/3/12 Organization | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| 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 |
| 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 |
| SHIVES, AARON Individual | adp of the snf | NOT APPLICABLE | 07/01/2019 |
| SPEIER, LYNNA Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| WATERTOWN SD PROPERTY HOLDINGS, LLC Organization | 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 |
| RAJCHENBACH, CHAIM Individual | operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| SHABAT, MENACHEM Individual | operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| SHIVES, AARON Individual | operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| SPEIER, LYNNA Individual | operational/managerial control | NOT APPLICABLE | 10/01/2025 |
| TRUIST BANK Organization | operational/managerial control | NOT APPLICABLE | 04/01/2022 |
Other nursing homes near Avantara Watertown
- ★★★★★3Average
Estelline Nursing and Care Center
205 Fjerestad Avenue East, Estelline, SD 57234 · 20.9 mi
Government · 60 beds
★★★★★4Above averageAvantara Lake Norden
803 Park Street, Lake Norden, SD 57248 · 22.9 mi
For-profit · 50 beds · Part of Legacy Healthcare
★★★★★5Much above averageAvantara Clark City
201 8th Avenue NW, Clark, SD 57225 · 30.9 mi
For-profit · 35 beds · Part of Legacy Healthcare
★★★★★4Above averageAvantara Milbank
1103 South Second Street, Milbank, SD 57252 · 31.1 mi
For-profit · 55 beds · Part of Legacy Healthcare
★★★★★1Much below average- ★★★★★2Below average
Frequently asked questions
What is Avantara Watertown's rating?
Avantara Watertown 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 Watertown receive?
Its most recent standard health inspection found 26 citations, compared with a South Dakota average of 6.7. Every citation is listed on this page with its severity.
Does Avantara Watertown 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 Watertown?
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 Watertown and how do I contact it?
Avantara Watertown is at 415 Fourth Ave NE, Watertown, SD 57201. Phone: (605) 886-8431.
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.