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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 boasts its one-of-a-kind superior care that creates an atmosphere of comfort and security for a distinct living focused on relaxation and recovery. As one of South Dakota’s most trusted nursing homes, there is a merit of an incomparable level of care that provokes quality service delivered by only the best team of professionals who offer tailored personal care plans for each unique individual. Avantara Milbank has the privilege of maximizing advanced medical services that lead to an enhanced caliber of life.
The areas of excellence are found in the range of an array of specialized services such as community spaces, Wi-Fi all throughout, and an on-site full service salon; rehabilitation services include cardiac care, bariatric care, G-tube, IV therapy, orthopedic care, oncology care, stroke recovery, wound care, and memory care.
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 41st out of 64 homes in South Dakota.| Staff type | Hours / day | 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.
| 47m per day | ■ Avg State avg: 48m 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.
| 29m per day | ■ Avg 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 56m per day | ▼ 26% State avg: 2h 37m per day · National avg: 2h 21m per day |
|
Total Nursing (Weekend)
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 | ▼ 17% State avg: 3h 19m per day · National avg: 3h 26m 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.
| 4m per day | ▲ 33% State avg: 3m per day · National avg: 4m per day |
|
RN (Weekend)
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 |
Most residents typically stay for a few weeks or months before returning home or moving on.
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.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #41 / 61Payroll — state benchmarkedThis home is ranked 41st out of 61 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.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Lower than the South Dakota average: 79.9%Avantara Milbank is administrated by Dorscher, Keisha.
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.
Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.
Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.
South Dakota average: 19 deficiencies
The most recent inspection on March 13, 2025, identified deficiencies related to improper use of mechanical and non-mechanical sit-to-stand lifts, resulting in two residents being lowered to the floor without the required assistance of two staff members. Earlier inspections noted issues with resident transfer notifications, call light response times, food service hygiene, medication errors including administration of two long-acting insulins causing hypoglycemia and hospitalization, inadequate abuse investigations and reporting, hydration problems leading to dehydration and hospitalization, and incomplete assistance with activities of daily living. Complaint investigations substantiated failures in lift use, medication error reporting, abuse investigations, and grievance handling, while most other complaints were unsubstantiated. Enforcement actions included suspension and education of involved staff, but fines or license actions were not listed in the available reports. The inspection history shows recurring themes around resident safety during transfers, medication management, and timely care assistance, with no clear pattern of overall improvement or worsening.
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
6
233% worse than South Dakota averageSouth Dakota average: 1.8
Issues related to food quality, meal service, and resident's nutritional needs.
Mar 13, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 13, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Mar 13, 2025
Corrected
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Mar 13, 2025
Corrected
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
| Alcester Care and Rehab 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. | Alcester (Alcester Township) | 41 | 94.9% | +19% | 3.72 | +30% | -14% | 2 | 11 | 2.2 | 1 | 37 | - | - | Stroschein Properties Iii Llc | $3.0M | $1.5M | 50.6% | 435062 | ||||
| Avantara Clark City |
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. | Clark | 35 | 79.4% | -1% | 3.15 | -22% | -27% | 1 | 5 | 1.3 | 1 | 31 | - | 31 | Schlomer, Tiffany | $6.0M | $1.5M | 25.5% | 435058 | ||||
| Aurora Brule Nursing Home Inc. |
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. | White Lake (White Lake Township) | 50 | 61.7% | -23% | 3.45 | +29% | -20% | 2 | 16 | 3.2 | 1 | 40 | - | - | Aurora-Brule Nursing Home | $2.9M | $1.5M | 51.8% | 435132 | ||||
| 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 | 67.7% | -15% | 3.38 | +12% | -22% | 3 | 18 | 3.0 | 6 | 31 | - | 27 | Lohre, Celina | $7.5M | $2.0M | 27.2% | 435009 | ||||
| Avantara Arrowhead |
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. | Rapid City (Broadmoor Subdivision) | 68 | 75.2% | -6% | 2.80 | +52% | -36% | 5 | 34 | 3.8 | 9 | 61 | - | 12 | Preston, Philip | $10.7M | $2.9M | 27.3% | 435051 |
0.7 miles from city center
Estimated distance in miles from Milbank's city center to Avantara Milbank's address, calculated via Google Maps.
— 1.14 miles to nearest hospital (Milbank Area Hospital Avera)
Add your location
This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
11% better than South Dakota averageSouth Dakota average ratio: 1.91:1
0% compared with South Dakota averageSouth Dakota average: 7.7 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.1 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.4 hoursThis role is partially covered by contractors.
Total hours from contractors
2,416 contractor hours this quarter
| Certified Nursing Assistant | 24 | 11 | 35 | 4,826 | 91 | 100% | 7.4 |
| Licensed Practical Nurse | 3 | 4 | 7 | 1,785 | 91 | 100% | 10.1 |
| Registered Nurse | 4 | 5 | 9 | 1,374 | 82 | 90% | 9.7 |
| Administrator | 3 | 0 | 3 | 568 | 64 | 70% | 8 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 565 | 51 | 56% | 8.6 |
| Nurse Practitioner | 1 | 1 | 2 | 563 | 64 | 70% | 8.1 |
| Dental Services Staff | 1 | 0 | 1 | 475 | 60 | 66% | 7.9 |
| Dietitian | 1 | 0 | 1 | 448 | 56 | 62% | 8 |
| Speech Language Pathologist | 0 | 1 | 1 | 446 | 64 | 70% | 7 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 225 | 53 | 58% | 4.3 |
| Other Dietary Services Staff | 2 | 0 | 2 | 209 | 53 | 58% | 3.7 |
| Physical Therapy Aide | 0 | 4 | 4 | 179 | 48 | 53% | 3.6 |
| Physical Therapy Assistant | 0 | 2 | 2 | 80 | 29 | 32% | 2.7 |
| Qualified Social Worker | 0 | 1 | 1 | 65 | 24 | 26% | 2.7 |
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.
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
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
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%
Number of hospitalizations per 1,000 long-stay resident days.
0.75
50% better than South Dakota averageSouth Dakota average: 1.51
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.77
In line with South Dakota averageSouth Dakota average: 1.85
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
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%
Percentage of SNF residents who experience falls with major injury during their stay.
4.4%
465% worse than South Dakota averageSouth Dakota average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
20.0%
63% worse than South Dakota averageSouth Dakota average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
35.1%
31% worse than South Dakota averageSouth Dakota average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
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.
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
Historical financial and operational data for Avantara Milbank based on CMS SNF Cost Reports.
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