2/5
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.
2/5
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 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 44th out of 65 homes in South Dakota for nurse hours. 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 |
|---|---|---|
|
Registered Nurse (RN)
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.
| 59m per day | ▲ 19% State avg: 49m per day · National avg: 41m per day |
|
LPN / LVN
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.
| 14m per day | ▼ 51% State avg: 29m per day · National avg: 52m per day |
|
Nurse Aide
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.
| 1h 47m per day | ▼ 31% State avg: 2h 34m per day · National avg: 2h 20m per day |
|
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 45m per day | ▼ 19% State avg: 3h 23m per day · National avg: 3h 27m per day |
|
Physical Therapist
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.
| 3m per day | ■ Avg State avg: 3m per day · National avg: 4m per day |
|
Weekend RN
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.
| 42m per day | ▲ 35% State avg: 31m per day · National avg: 29m per day |
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Avantara Milbank is administered 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, 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.
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 inspection
Average deficiencies per inspection.
| 3.2 | 3.8 | This facility has 16% fewer deficiencies per inspection than a typical South Dakota nursing home (3.2 vs. SD avg 3.8).↓ 16% better |
Inspections
| This Facility | SD Average | vs. SD Avg |
|---|---|---|---|
|
Total inspections
Combined count of all inspections conducted at this facility.
| 6 | 5 | This facility has had 20% more total inspections than the South Dakota average (6 vs. SD avg 5). More inspections can mean more regulatory scrutiny rather than worse care.↑ 20% more |
State average 4.5
Last Health inspection on Mar 2025
State average 14.8
State 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 State averageState average: 0.3
233% worse than State averageState average: 1.8
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
63% more staff per resident 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 from 2011–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
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."
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."
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."
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."
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.
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 #38 / 63Payroll — State benchmarkedThis home is ranked 38th out of 63 homes in South Dakota for payroll. 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.Facilities with the same value for a metric share the same 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.
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 #40 / 63Payroll % — State benchmarkedThis home is ranked 40th out of 63 homes in South Dakota for payroll %. 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.Facilities with the same value for a metric share the same 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.
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).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Most residents typically stay for a few weeks or months before returning home or moving on.
New residents most often arrive under Medicare (48% of admissions), and a typical Medicare stay runs around 1 - 2 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Milbank's city center to Avantara Milbank's address, calculated via Google Maps.
Add your location
Info below is compiled from CMS reports & the SD Dept. of Health (DOH), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
| Avera Maryhouse | NH AL HOS | Pierre | 67
Facility
67
SD AVG
69
Rank
#49 / 117 | - | - | 5.30
Facility
5.30
SD AVG
4.34
Rank
#7 / 65 | +18% | +22% | $0
Facility
$0
SD AVG
$38.5k
Rank
#1 / 67 | 9
Facility
9
SD AVG
14.8
Rank
#17 / 65 | 2.3
Facility
2.3
SD AVG
3.3
Rank
#19 / 65 | - | 59 | - |
60
Facility
60
SD AVG
39
Rank
#38 / 158 | - | - | - | - | 435034 | ||||
| Prairie Heights Healthcare | NH HOS SNF | Nw Aberdeen | 99
Facility
99
SD AVG
69
Rank
#21 / 117 |
62.9%
Facility
62.9%
SD AVG
82.2
Rank
#31 / 34 | -23% | 3.86
Facility
3.86
SD AVG
4.34
Rank
#28 / 65 | -39% | -11% | $0
Facility
$0
SD AVG
$38.5k
Rank
#1 / 67 | 5
Facility
5
SD AVG
14.8
Rank
#4 / 65 | 1.7
Facility
1.7
SD AVG
3.3
Rank
#12 / 65 | - | 62 | - |
85
Facility
85
SD AVG
39
Rank
#1 / 158 | - | $11.3MFiscal year ending 12/2023
Facility
$11.3MFiscal year ending 12/2023
SD AVG
$6.7M
Rank
#13 / 63 | $6.1MFiscal year ending 12/2023
Facility
$6.1MFiscal year ending 12/2023
SD AVG
$2.6M
Rank
#15 / 63 | 54.4%Fiscal year ending 12/2023
Facility
54.4%Fiscal year ending 12/2023
SD AVG
40.8%
Rank
#31 / 63 | 435004 | ||||
| Bethesda Home of Aberdeen | NH AL HC RC SNF | Aberdeen (Aberdeen Township) | 86
Facility
86
SD AVG
69
Rank
#27 / 117 | - | - | 5.08
Facility
5.08
SD AVG
4.34
Rank
#11 / 65 | +1% | +17% | $0
Facility
$0
SD AVG
$38.5k
Rank
#1 / 67 | 6
Facility
6
SD AVG
14.8
Rank
#8 / 65 | 2.0
Facility
2.0
SD AVG
3.3
Rank
#15 / 65 | - | 45 | - |
85
Facility
85
SD AVG
39
Rank
#1 / 158 | Christian Retirement Center Of Northern California | $4.5MFiscal year ending 12/2023
Facility
$4.5MFiscal year ending 12/2023
SD AVG
$6.7M
Rank
#50 / 63 | $3.3MFiscal year ending 12/2023
Facility
$3.3MFiscal year ending 12/2023
SD AVG
$2.6M
Rank
#37 / 63 | 73%Fiscal year ending 12/2023
Facility
73%Fiscal year ending 12/2023
SD AVG
40.8%
Rank
#17 / 63 | 435071 | ||||
| Bethany Home Sioux Falls/Bethany Home-Brandon | NH AL IL MC SNF | Sioux Falls | 112
Facility
112
SD AVG
69
Rank
#11 / 117 | - | - | 5.47
Facility
5.47
SD AVG
4.34
Rank
#5 / 65 | -15% | +26% | $0
Facility
$0
SD AVG
$38.5k
Rank
#1 / 67 | 13
Facility
13
SD AVG
14.8
Rank
#27 / 65 | 3.3
Facility
3.3
SD AVG
3.3
Rank
#35 / 65 | 1 | 43 | - |
65
Facility
65
SD AVG
39
Rank
#24 / 158 | Augustana Lutheran Church | $5.9MFiscal year ending 06/2024
Facility
$5.9MFiscal year ending 06/2024
SD AVG
$6.7M
Rank
#41 / 63 | $4.1MFiscal year ending 06/2024
Facility
$4.1MFiscal year ending 06/2024
SD AVG
$2.6M
Rank
#23 / 63 | 68.6%Fiscal year ending 06/2024
Facility
68.6%Fiscal year ending 06/2024
SD AVG
40.8%
Rank
#12 / 63 | 435096 | ||||
| Avantara Milbank | NH HOS MC SNF | Milbank | 45
Facility
45
SD AVG
69
Rank
#82 / 117 | - | - | 3.38
Facility
3.38
SD AVG
4.34
Rank
#44 / 65 | +6% | -22% | $55.4k
Facility
$55.4k
SD AVG
$38.5k
Rank
#54 / 67 | 18
Facility
18
SD AVG
14.8
Rank
#35 / 65 | 3.0
Facility
3.0
SD AVG
3.3
Rank
#27 / 65 | 6 | 41 | - |
64
Facility
64
SD AVG
39
Rank
#29 / 158 | Celina Lohre | $4.4MFiscal year ending 12/2023
Facility
$4.4MFiscal year ending 12/2023
SD AVG
$6.7M
Rank
#34 / 63 | $2.5MFiscal year ending 12/2023
Facility
$2.5MFiscal year ending 12/2023
SD AVG
$2.6M
Rank
#38 / 63 | 57.3%Fiscal year ending 12/2023
Facility
57.3%Fiscal year ending 12/2023
SD AVG
40.8%
Rank
#40 / 63 | 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.
Avantara Milbank's occupancy is 67.7%.
Avantara Milbank has been operating for approximately 1 year, based on available licensing and registration records.
No, Avantara Milbank has a no-pet policy.
Avantara Milbank is registered as a for-profit in SD.
Keisha Dorscher is the administrator of Avantara Milbank.
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