Avantara Lake Norden
Nursing Home, Hospice Care & Memory Care · Lake Norden, SD
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.

Avantara Lake Norden

Nursing Home, Hospice Care & Memory Care · Lake Norden, SD
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
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Avantara Lake Norden accepts Medicare, Medicaid, and private pay.

Overview of Avantara Lake Norden

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.

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
Health Inspection Info 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.
Staffing Info 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.
Quality Measures Info 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.

Staffing hours breakdown

Info 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.

Hours per resident per day — compared to state averages

Total nursing care / resident Info 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.
3h 20m per day
Rank #50 / 65Nurse hours — State benchmarkedThis home is ranked 50th out of 65 homes in South Dakota. Shows adjusted nurse hours per resident per day benchmarked to the South Dakota average, with a ranking across 65 South Dakota facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs avg
Staff typeHours / Day / Residentvs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 47m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 18m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 2h 6m per day
Weekend Total Nursing Info 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 50m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation. 2m per day
Weekend RN Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent. 27m per day

Capacity and availability

Avg. Length of Stay
175 days
Bed community size
50-bed community Rank #68 / 117Bed count — State benchmarkedThis home is ranked 68th out of 117 homes in South Dakota. Shows this facility's certified or reported bed count compared to other South Dakota facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A moderately sized community that may balance personal attention with shared amenities and social activities.
Walk Score
Walk Score: 11 / 100 Rank #131 / 159Walk Score — State benchmarkedThis home is ranked 131st out of 159 homes in South Dakota. Shows how walkable this facility's neighborhood is compared to the average Walk Score across South Dakota facilities. Higher scores benefit residents, families, and staff.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Car-dependent. Most errands require a car, with limited nearby walkable options.

About this community

Occupancy

Occupancy rate
92%
Rank #11 / 62Occupancy rate — State benchmarkedThis home is ranked 11th out of 62 homes in South Dakota. Shows this facility's occupancy rate versus the South Dakota average, with its Statewide rank out of 62. Higher occupancy signals strong local demand and financial stability.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Higher than the South Dakota average: 79.9%
Occupied beds
46 / 50
Average occupied beds in South Dakota homes 51 beds

License Details

Facility TypeNursing Home
StatusActive
IssuanceJuly 1, 2025
ExpirationJune 30, 2026 Expires in 4 days
CountyHamlin
License Number10639
CMS Certification Number435059

Ownership & Operating Entity

Avantara Lake Norden is administered by Margaret Grimm.

Therapy & Rehabilitation

2 services
Rehabilitation Services
Short-Term Rehab

Amenities & Lifestyle

Specific ProgramsSecured Memory Care Unit, Stroke And Other Neurological Conditions, Cardiac Care, Oncology Recovery Care, Orthopedic Rehabilitation, Pulmonary Care

Contact Avantara Lake Norden

Inspection History

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.

Since 2023 · 3 years of data 4 deficiencies 3 inspections

Inspection Scorecard Info This scorecard compares key inspection, deficiency, 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.

Since 2023 vs. South Dakota state average
Overall vs. SD average 0 Worse No metrics in this bucket. 4 Better Metrics better than South Dakota average:
• Total deficiencies (79% below)
• Deficiencies per year (79% below)
• Deficiencies per inspection (59% below)
• Total inspections (50% below)
Latest Inspection March 20, 2025 Routine

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This FacilitySD Averagevs. SD Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 419 This facility has 79% fewer total deficiencies than a typical South Dakota assisted living residence (4 vs. SD avg 19).↓ 79% better
Deficiencies per year Info Average deficiencies per year since 2023. 1.36.3 This facility has 79% fewer deficiencies per year than a typical South Dakota assisted living residence (1.3 vs. SD avg 6.3).↓ 79% better
Deficiencies per inspection Info Average deficiencies per inspection. 1.33.2 This facility has 59% fewer deficiencies per inspection than a typical South Dakota assisted living residence (1.3 vs. SD avg 3.2).↓ 59% better

Inspections Info State inspections evaluate whether the facility meets health and safety standards.

This FacilitySD Averagevs. SD Avg
Total inspections Info Combined count of all routine and focused inspections. Excludes complaint investigations. 36 This facility has 50% fewer total inspections than a typical South Dakota assisted living residence (3 vs. SD avg 6).↓ 50% better

Health Inspection History

Inspections since 2023
Total health inspections 3

State average N/A


Last Health inspection on Mar 2025

Total health citations
4 Rank #2 / 67Health citations — State benchmarkedThis home is ranked 2nd out of 67 homes in South Dakota. Shows this facility's total health deficiency citations benchmarked to the South Dakota State average, with a ranking across all 67 SD facilities. Lower citation counts earn a better rank.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Citations per inspection
1.33 Rank #5 / 67Citations per inspection — State benchmarkedThis home is ranked 5th out of 67 homes in South Dakota. Shows average deficiency citations per CMS inspection for this facility versus the South Dakota mean across 67 facilities with citation data. Lower is better.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

All 4 citations resulted from standard inspections.

Breakdown of citation severity (last 3 years)
Critical health citations
0
In line with State average

State average: N/A


Serious health citations
1
In line with State average

State average: N/A

0 critical citations State average: N/A

1 serious citation State average: N/A

2 moderate citations State average: N/A

1 minor citation State average: N/A
Citations history (last 3 years)
Care Planning minor citation Mar 20, 2025
Corrected

Infection Control moderate citation Nov 16, 2023
Corrected

Care Planning moderate citation Nov 16, 2023
Corrected

Quality of Care serious citation Jan 19, 2023
Corrected

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 94
Employees 59
Contractors 35
Staff to resident ratio 2.04 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 26
Average shift 6.7 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 16,139

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info 8 total: 5 full-time employees and 3 contractors. 8
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.1 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info 7 total: 5 full-time employees and 2 contractors. 7
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info 52 total: 39 full-time employees and 13 contractors. 52
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 6.8 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

10.4%

1,679 contractor hours this quarter

Certified Nursing Assistant: 13 Respiratory Therapy Technician: 6 Physical Therapy Aide: 4 Registered Nurse: 3 Speech Language Pathologist: 3 Physical Therapy Assistant: 2 Licensed Practical Nurse: 2 Qualified Social Worker: 2

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant3913528,85692100%6.8
Registered Nurse5381,95692100%9.1
Licensed Practical Nurse5271,2698491%8.4
Clinical Nurse Specialist2029326470%7.8
Dietitian2028486166%7.6
Administrator1014946368%7.8
Nurse Practitioner3034806368%7.6
Mental Health Service Worker1014655964%7.9
Speech Language Pathologist0332255964%3.7
Respiratory Therapy Technician0661704043%4.2
Physical Therapy Aide0441626166%2.6
Qualified Social Worker0221404448%3.2
Medication Aide/Technician101773033%2.6
Physical Therapy Assistant022662527%2.6
52 Certified Nursing Assistant
% of Days 100%
8 Registered Nurse
% of Days 100%
7 Licensed Practical Nurse
% of Days 91%
2 Clinical Nurse Specialist
% of Days 70%
2 Dietitian
% of Days 66%
1 Administrator
% of Days 68%
3 Nurse Practitioner
% of Days 68%
1 Mental Health Service Worker
% of Days 64%
3 Speech Language Pathologist
% of Days 64%
6 Respiratory Therapy Technician
% of Days 43%
4 Physical Therapy Aide
% of Days 66%
2 Qualified Social Worker
% of Days 48%
1 Medication Aide/Technician
% of Days 33%
2 Physical Therapy Assistant
% of Days 27%

Penalties and fines

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)

Total fines amount $11K Rank #1 / 67Federal fines — State benchmarkedThis home is ranked 1st out of 67 homes in South Dakota. Shows this facility's cumulative CMS federal fine dollars versus the South Dakota average among facilities with fines, and where it ranks among 67 facilities in the pool. Lower total dollars mean a better rank.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
73% lower than State average

State average: $40K

Number of fines 1
51% fewer fines than State average

State average: 2.0

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
In line with State average

State average: 0.0

Fines amount comparison
Fines amount comparison
This facility $11K
State average $40K

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info 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 State average

State average: 12.0

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 28.7
20% worse than State average

State average: 23.9

Long-stay resident measures
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 28.4%
27% worse than State average

State average: 22.3%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 27.7%
21% worse than State average

State average: 22.8%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 29.9%
12% worse than State average

State average: 26.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 4.9%
In line with State average

State average: 5.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 2.0%
57% better than State average

State average: 4.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 1.3%
63% better than State average

State average: 3.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 2.0%
63% better than State average

State average: 5.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 4.6%
11% worse than State average

State average: 4.1%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 18.7%
23% better than State average

State average: 24.4%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 98.8%
In line with State average

State average: 95.7%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 97.6%
In line with State average

State average: 96.9%

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 95.0%
13% better than State average

State average: 84.4%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.0%
100% better than State average

State average: 1.8%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 97.0%
24% better than State average

State average: 78.2%

Breakdown by payment type

Medicare

40% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

39% of new residents, often for short stays.

Typical stay 4 - 5 months

Medicaid

21% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 46
Medicare
5
10.9% of residents
Medicaid
27
58.7% of residents
Private pay or other
14
30.4% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

For-profit
Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.5M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$241.5K
For-profit Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.5M Rank #41 / 63Revenue — State benchmarkedThis home is ranked 41st out of 63 homes in South Dakota. Shows this facility's annual revenue compared to the South Dakota average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$241.5K
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$4.4K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #42 / 63Payroll — State benchmarkedThis home is ranked 42nd out of 63 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.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$2.5M 56.2% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #44 / 63Payroll % — State benchmarkedThis home is ranked 44th out of 63 homes in South Dakota. Shows payroll as a percentage of revenue versus the South Dakota average. Well-run South Dakota facilities typically land around 64–73% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$1.7M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$4.3M

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

New residents most often arrive under Medicare (40% of admissions), and a typical Medicare stay runs around 1 - 2 months.

Admissions
87 total

Coverage residents most often arrive under.

Medicare 40%
Private pay 39%
Medicaid 21%
Discharges
92 total

Coverage residents most often leave under.

Medicare 24%
Private pay 34%
Medicaid 42%

Places of interest near Avantara Lake Norden

Address 0.0 miles from city center Info Estimated distance in miles from Lake Norden's city center to Avantara Lake Norden's address, calculated via Google Maps.

Calculate Travel Distance to Avantara Lake Norden

Add your location

Address

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Frequently Asked Questions about Avantara Lake Norden

Is Avantara Lake Norden in a walkable area?

Avantara Lake Norden has a walk score of 11. Car-dependent. Most errands require a car, with limited nearby walkable options.

What is the license number of Avantara Lake Norden?

According to SD state health department records, Avantara Lake Norden's license number is 10639.

When does Avantara Lake Norden's license expire?

According to SD state health department records, Avantara Lake Norden's license expires on June 30, 2026.

What is the occupancy rate at Avantara Lake Norden?

Avantara Lake Norden's occupancy is 92%.

Does Avantara Lake Norden operate as a for-profit or non-profit?

Avantara Lake Norden is registered as a for-profit in SD.

Who is the administrator of Avantara Lake Norden?

Margaret Grimm is the administrator of Avantara Lake Norden.

How many beds does Avantara Lake Norden have?

Avantara Lake Norden has 50 beds.

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