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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 Milbank is a nursing home in Milbank, South Dakota, focused primarily on short-term recovery and post-acute care services for older adults. Privately owned and operated, this 45-bed community is currently operating at a 68% occupancy rate, which is lower than the state average and suggests availability for immediate placements. Furthermore, it serves a resident population largely composed of Medicare and private-pay individuals, with an average length of stay of approximately 127 days, which reflects its rehabilitation-centered approach rather than long-term custodial care.
The community underwent six inspections and received 18 citations over the past seven years, a figure above the South Dakota average. Between late 2023 and the end of 2024, three federal penalties were issued related to regulatory deficiencies. Six citations were also categorized as serious in severity, substantially higher than the statewide average, highlighting areas of compliance concern.
Additionally, the most recent inspection, completed in March 2025, identified deficiencies involving quality of care, resident rights, and nutrition services, all of which were subsequently corrected. Notably, the community has not recorded any immediate jeopardy findings or critical-level citations.
Staffing levels align with the community’s focus on rehabilitation and transitional care, with an average of 3 hours and 23 minutes of nursing care daily, which is slightly below the South Dakota average. Certified nursing assistants also make up the largest share of direct care staffing, while contract staff account for roughly 20% of total staffing hours.
Clinical programming focuses heavily on post-acute recovery and includes specialized support for post-surgical rehabilitation, stroke recovery, cardiac care, orthopedic rehabilitation, and pulmonary care. These services are designed for residents recovering from hospitalization or complex medical events who require time-limited skilled nursing oversight and therapy before returning home or transitioning to a lower level of care.
Focusing on post-acute therapy and specialized rehabilitation services, Avantara Milbank is best suited for older adults in the Milbank area seeking short-term rehabilitation and clinically focused recovery support within a moderately sized community.
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 38th 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 46m per day | ▼ 16% State avg: 3h 17m per day · National avg: 3h 25m per day |
Lower than the South Dakota average: 79.9%Avantara Milbank is administrated by Keisha Dorscher.
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.
| 19 | 19 | This facility has total deficiencies in line with the South Dakota average (19 vs. SD avg 19).— At avg |
|
Deficiencies per year
Average deficiencies per year since 2022.
| 4.8 | 4.8 | This facility has deficiencies per year in line with the South Dakota average (4.8 vs. SD avg 4.8).— At avg |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 3.2 | 3.2 | This facility has deficiencies per inspection in line with the South Dakota average (3.2 vs. SD avg 3.2).— At avg |
Inspections
| This Facility | SD Average | vs. SD Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 6 | 6 | This facility has total inspections in line with the South Dakota average (6 vs. SD avg 6).— At avg |
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.
10 of 18 citations resulted from standard inspections; and 8 of 18 resulted from complaint investigations.
100% better than South Dakota averageSouth Dakota average: 0.3
233% worse 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.
63% better than South Dakota average
10% better 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.
13 total: 4 full-time employees and 9 contractors.
13
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.8 hoursAssists with medical care and medications.
8 total: 1 full-time employee and 7 contractors.
8
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.4 hoursHelps with daily care and mobility.
69 total: 20 full-time employees and 49 contractors.
69
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
7,163 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 20 | 49 | 69 | 6,751 | 92 | 100% | 8.7 |
| Registered Nurse | 4 | 9 | 13 | 3,090 | 92 | 100% | 10.8 |
| Licensed Practical Nurse | 1 | 7 | 8 | 892 | 60 | 65% | 10.4 |
| Administrator | 2 | 0 | 2 | 712 | 64 | 70% | 8 |
| Nurse Practitioner | 1 | 1 | 2 | 514 | 61 | 66% | 8.4 |
| Dietitian | 1 | 0 | 1 | 472 | 59 | 64% | 8 |
| Speech Language Pathologist | 0 | 2 | 2 | 409 | 57 | 62% | 6.6 |
| Dental Services Staff | 1 | 0 | 1 | 384 | 48 | 52% | 8 |
| Physical Therapy Aide | 0 | 4 | 4 | 263 | 59 | 64% | 4.4 |
| Other Dietary Services Staff | 3 | 0 | 3 | 233 | 39 | 42% | 5.7 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 197 | 48 | 52% | 4.1 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 104 | 13 | 14% | 8 |
| Physical Therapy Assistant | 0 | 2 | 2 | 67 | 27 | 29% | 2.5 |
| Qualified Social Worker | 0 | 1 | 1 | 64 | 24 | 26% | 2.7 |
Includes penalties issued in 2023-2024
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)
98% higher than South Dakota averageSouth Dakota average: $40K
48% more 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
Penalties are imposed by CMS for violations of federal nursing home regulations.
3 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Dec 18, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 8, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 8, 2023Last updated: Jan 2026
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.
17.6
46% worse than South Dakota averageSouth Dakota average: 12.0
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
29.8
25% worse than South Dakota averageSouth Dakota average: 23.9
Percent of long-stay residents whose need for help with daily activities has increased
27.2%
22% worse than South Dakota averageSouth Dakota average: 22.3%
Percent of long-stay residents whose ability to move independently worsened
39.8%
74% worse than South Dakota averageSouth Dakota average: 22.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
22.5%
16% better than South Dakota averageSouth Dakota average: 26.7%
Percent of long-stay residents experiencing one or more falls with major injury
4.4%
13% better than South Dakota averageSouth Dakota average: 5.0%
Percent of long-stay high risk residents with pressure ulcers
9.8%
119% worse than South Dakota averageSouth Dakota average: 4.5%
Percent of long-stay residents with a urinary tract infection
3.0%
14% better than South Dakota averageSouth Dakota average: 3.5%
Percent of long-stay residents who lose too much weight
6.8%
24% worse than South Dakota averageSouth Dakota average: 5.5%
Percent of long-stay residents who have depressive symptoms
8.2%
101% worse than South Dakota averageSouth Dakota average: 4.1%
Percent of long-stay residents who received an antipsychotic medication
27.3%
12% worse than South Dakota averageSouth Dakota average: 24.4%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
68.6%
28% worse than South Dakota averageSouth Dakota average: 95.7%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.3%
In line with South Dakota averageSouth Dakota average: 96.9%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
30.9%
63% worse than South Dakota averageSouth Dakota average: 84.4%
Percent of short-stay residents who newly received an antipsychotic medication
3.7%
111% worse than South Dakota averageSouth Dakota average: 1.8%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
48% of new residents, usually for short-term rehab.
35% of new residents, often for short stays.
17% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
35Residents meet regularly to discuss policies, care quality, and activities
Family members meet regularly to discuss policies, care quality, and activities
Organized group of family members that meets regularly to discuss facility policies, resident care, and activities.
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 Milbank 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 #30 / 55Payroll — State benchmarkedThis home is ranked 30th 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 Milbank's city center to Avantara Milbank's address, calculated via Google Maps.
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Avantara Milbank is located in Milbank, 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.
| 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 Milbank |
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. | Milbank | 45
Facility
45
SD AVG
69
Rank
#82 / 117 | 67.7% | -15% | 3.38 | +6% | -22% | $79.0k | 18 | 3.0 | 6 | 31 |
64
Facility
64
SD AVG
39
Rank
#30 / 159 | Celina Lohre | $7.5M | $3.2M | 42.9% | 435009 |
Avantara Milbank has a walk score of 64. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to SD state health department records, Avantara Milbank's license number is 10650.
According to SD state health department records, Avantara Milbank's license expires on June 30, 2026.
Avantara Milbank's occupancy is 68%.
Keisha Dorscher is the administrator of Avantara Milbank.
Avantara Milbank has 45 beds.
Yes — there are 4 photos of Avantara Milbank in the photo gallery on this page.
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