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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Avantara Lake Norden is a privately owned nursing home in Lake Norden, South Dakota, that offers memory care, short-term rehabilitation, and specialized clinical support services. The 50-bed community is owned and administered by Margaret Grimm and operates under an active CMS certification. Medicare, Medicaid, and private-pay residents are accepted, providing flexibility for a variety of care needs and financial situations.
The community holds a 5-star overall CMS rating, the highest designation available, and performs substantially above South Dakota averages across multiple quality categories. Health inspection scores rank exceptionally high, while quality measures also exceed statewide benchmarks by a wide margin, reflecting strong regulatory performance and positive resident outcomes. Staffing ratings are modestly above average according to CMS methodology, although raw nursing hours per resident remain somewhat below state averages. Weekend nursing coverage also averages 2 hours and 44 minutes daily.
The community has an occupancy rate of 92%, reflecting sustained demand and local confidence in the community’s services. Medicare residents typically remain for one to two months, while private-pay residents often stay several months longer. The average overall length of stay is approximately 175 days.
Secured memory care services are a particularly important differentiator in the region, offering support for individuals living with Alzheimer’s disease or other forms of dementia in an area where specialized memory care options may be limited.
Avantara Lake Norden is ideal for older adults and families seeking a highly rated skilled nursing community with memory care capabilities, strong inspection outcomes, and a reputation supported by high occupancy and sustained community demand in Hamlin County and eastern South Dakota.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 43rd out of 57 homes in South Dakota. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 2h 44m per day | ▼ 17% State avg: 3h 17m per day · National avg: 3h 25m per day |
Higher than the South Dakota average: 79.9%Avantara Lake Norden is administrated by Margaret Grimm.
In South Dakota, the Department of Health, Office of Health Care Facilities Licensure is the state agency responsible for conducting unannounced surveys and monitoring facility quality.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the South Dakota state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | SD Average | vs. SD Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 4 | 19 | This facility has 79% fewer total deficiencies than a typical South Dakota nursing home (4 vs. SD avg 19).↓ 79% better |
|
Deficiencies per year
Average deficiencies per year since 2023.
| 1.3 | 6.3 | This facility has 79% fewer deficiencies per year than a typical South Dakota nursing home (1.3 vs. SD avg 6.3).↓ 79% better |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 1.3 | 3.2 | This facility has 59% fewer deficiencies per inspection than a typical South Dakota nursing home (1.3 vs. SD avg 3.2).↓ 59% better |
Inspections
| This Facility | SD Average | vs. SD Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 3 | 6 | This facility has 50% fewer total inspections than a typical South Dakota nursing home (3 vs. SD avg 6).↓ 50% better |
South Dakota average 4.5
Last Health inspection on Mar 2025
South Dakota average 14.8
South Dakota average 3.34
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 4 citations resulted from standard inspections.
100% better than South Dakota averageSouth Dakota average: 0.3
44% better than South Dakota averageSouth Dakota average: 1.8
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
6% better than South Dakota average
13% worse than South Dakota average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
8 total: 5 full-time employees and 3 contractors.
8
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.1 hoursAssists with medical care and medications.
7 total: 5 full-time employees and 2 contractors.
7
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursHelps with daily care and mobility.
52 total: 39 full-time employees and 13 contractors.
52
Average shift length. Calculated as total hours divided by days worked and average staff per day.
6.8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,679 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 39 | 13 | 52 | 8,856 | 92 | 100% | 6.8 |
| Registered Nurse | 5 | 3 | 8 | 1,956 | 92 | 100% | 9.1 |
| Licensed Practical Nurse | 5 | 2 | 7 | 1,269 | 84 | 91% | 8.4 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 932 | 64 | 70% | 7.8 |
| Dietitian | 2 | 0 | 2 | 848 | 61 | 66% | 7.6 |
| Administrator | 1 | 0 | 1 | 494 | 63 | 68% | 7.8 |
| Nurse Practitioner | 3 | 0 | 3 | 480 | 63 | 68% | 7.6 |
| Mental Health Service Worker | 1 | 0 | 1 | 465 | 59 | 64% | 7.9 |
| Speech Language Pathologist | 0 | 3 | 3 | 225 | 59 | 64% | 3.7 |
| Respiratory Therapy Technician | 0 | 6 | 6 | 170 | 40 | 43% | 4.2 |
| Physical Therapy Aide | 0 | 4 | 4 | 162 | 61 | 66% | 2.6 |
| Qualified Social Worker | 0 | 2 | 2 | 140 | 44 | 48% | 3.2 |
| Medication Aide/Technician | 1 | 0 | 1 | 77 | 30 | 33% | 2.6 |
| Physical Therapy Assistant | 0 | 2 | 2 | 66 | 25 | 27% | 2.6 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
73% lower than South Dakota averageSouth Dakota average: $40K
51% fewer fines than South Dakota averageSouth Dakota average: 2.0
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0 
In line with South Dakota averageSouth Dakota average: 0.0
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
13.0
8% worse than South Dakota averageSouth Dakota average: 12.0
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
28.7
20% worse than South Dakota averageSouth Dakota average: 23.9
Percent of long-stay residents whose need for help with daily activities has increased
28.4%
27% worse than South Dakota averageSouth Dakota average: 22.3%
Percent of long-stay residents whose ability to move independently worsened
27.7%
21% worse than South Dakota averageSouth Dakota average: 22.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
29.9%
12% worse than South Dakota averageSouth Dakota average: 26.7%
Percent of long-stay residents experiencing one or more falls with major injury
4.9%
In line with South Dakota averageSouth Dakota average: 5.0%
Percent of long-stay high risk residents with pressure ulcers
2.0%
57% better than South Dakota averageSouth Dakota average: 4.5%
Percent of long-stay residents with a urinary tract infection
1.3%
63% better than South Dakota averageSouth Dakota average: 3.5%
Percent of long-stay residents who lose too much weight
2.0%
63% better than South Dakota averageSouth Dakota average: 5.5%
Percent of long-stay residents who have depressive symptoms
4.6%
11% worse than South Dakota averageSouth Dakota average: 4.1%
Percent of long-stay residents who received an antipsychotic medication
18.7%
23% better than South Dakota averageSouth Dakota average: 24.4%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.8%
In line with South Dakota averageSouth Dakota average: 95.7%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.6%
In line with South Dakota averageSouth Dakota average: 96.9%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
95.0%
13% better than South Dakota averageSouth Dakota average: 84.4%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than South Dakota averageSouth Dakota average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
97.0%
24% better than South Dakota averageSouth Dakota average: 78.2%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
40% of new residents, usually for short-term rehab.
39% of new residents, often for short stays.
21% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
46Residents meet regularly to discuss policies, care quality, and activities
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Avantara Lake Norden based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #34 / 55Payroll — State benchmarkedThis home is ranked 34th out of 55 homes in South Dakota. Shows total annual staff payroll benchmarked to the South Dakota average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
0.0 miles from city center
Estimated distance in miles from Lake Norden's city center to Avantara Lake Norden's address, calculated via Google Maps.
Add your location
Avantara Lake Norden is located in Lake Norden, South Dakota.
Here are the financial assistance programs available to residents in South Dakota.
The information below is reported by the South Dakota Department of Health, Office of Health Care Facilities Licensure.
| Avantara Lake Norden |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Lake Norden | 50
Facility
50
SD AVG
69
Rank
#68 / 117 | 92.1% | +15% | 3.33 | -24% | -23% | $10.6k | 4 | 1.3 | 1 | 47 |
11
Facility
11
SD AVG
39
Rank
#131 / 159 | Margaret Grimm | $7.1M | $3.0M | 42.3% | 435059 | ||||
| Avera Maryhouse |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary. | Pierre | 67
Facility
67
SD AVG
69
Rank
#49 / 117 | - | - | 5.30 | +18% | +22% | $0 | 9 | 2.3 | - | 58 |
60
Facility
60
SD AVG
39
Rank
#39 / 159 | - | - | - | - | 435034 | ||||
| Fountain Springs Healthcare Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Rapid City | 10
Facility
10
SD AVG
69
Rank
#116 / 117 | 87.3% | +9% | 3.82 | -2% | -12% | $32.3k | 11 | 1.6 | 2 | 86 |
16
Facility
16
SD AVG
39
Rank
#120 / 159 | - | $8.8M | $4.4M | 50.3% | 435110 | ||||
| Avera Mother Joseph Manor Retirement Community |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Aberdeen | 81
Facility
81
SD AVG
69
Rank
#32 / 117 | - | - | 4.62 | -24% | +6% | $20.6k | 12 | 1.7 | 3 | 77 |
31
Facility
31
SD AVG
39
Rank
#93 / 159 | - | - | - | - | 435042 |
Avantara Lake Norden has a walk score of 11. Car-dependent. Most errands require a car, with limited nearby walkable options.
According to SD state health department records, Avantara Lake Norden's license number is 10639.
According to SD state health department records, Avantara Lake Norden's license expires on June 30, 2026.
Avantara Lake Norden's occupancy is 92%.
Margaret Grimm is the administrator of Avantara Lake Norden.
Avantara Lake Norden has 50 beds.
Yes — there is 1 photo of Avantara Lake Norden in the photo gallery on this page.
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