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Avantara Watertown
Nursing Home, Hospice Care & Memory Care · Watertown, 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.
Exterior view of Avantara Watertown building Outdoor gazebo area with seating and pathways Dining area with tables and chairs Common area with tables and chairs in a well-lit room Interior rehabilitation gym with exercise equipment Avantara Watertown, Nursing Home in Watertown, SD — Nurse taking blood pressure of a senior resident Avantara Watertown, Nursing Home in Watertown, SD — Patient receiving care from a smiling medical professional Avantara Watertown, Nursing Home in Watertown, SD — Senior resident exercising with assistance in a fitness center Avantara Watertown, Nursing Home in Watertown, SD — Seniors engaging in physical therapy exercises together Avantara Watertown, Nursing Home in Watertown, SD — Doctor examining a senior man in a clinical setting Avantara Watertown, Nursing Home in Watertown, SD — Caregiver assisting a smiling elderly resident in a room Avantara Watertown, Nursing Home in Watertown, SD — Cozy shared bedroom with two neatly made beds Avantara Watertown, Nursing Home in Watertown, SD

Avantara Watertown

Nursing Home, Hospice Care & Memory Care · Watertown, 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.
415 4Th Ave. Ne, Watertown, SD 57201 View map Calculator: See prices in your area
Avantara Watertown accepts Medicare, Medicaid, and private pay.
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Avantara Watertown accepts Medicare, Medicaid, and private pay.

Overview of Avantara Watertown

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Forty-six beds are filled out of 51. Avantara Watertown runs at 90% occupancy, a solid number for a facility that only recently opened, sitting less than a mile from Prairie Lakes Hospital in Watertown’s 4th Avenue Northeast neighborhood. The address at 415 4th Ave. NE puts it in a moderately walkable part of the city (Walk Score 69), which matters for families who visit regularly.

At 168 days, the average length of stay sits in the middle range. This is not purely a 30-day Medicare rehab operation, but it’s also not a long-term custodial care setting by the numbers. The clinical menu reflects that positioning: stroke and neurological recovery, cardiac care, pulmonary care, oncology recovery, and orthopedic rehabilitation are the confirmed programs, all squarely in the post-acute specialty space. Administrator Lynna Speier leads a 51-bed facility in the Avantara network that is clearly built around structured medical recovery rather than extended residential care.

Registered nurses log 1 hour and 9 minutes per resident per day, with total nursing care at 3 hours and 35 minutes. Nurse aides account for 1 hour and 58 minutes of that total. Medicare, Medicaid, and private pay are all accepted.

Avantara Watertown is a compact, recently opened nursing home with a clinical program built for residents recovering from cardiac events, neurological incidents, cancer treatment, and orthopedic procedures, operating near hospital infrastructure that supports that care model.

(605) 886-8431
(605) 886-8431
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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.
▲ 47.3% Above SD avg. ▲ 47.3% Above SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▲ 47.9% Above SD avg. ▲ 47.9% Above SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▼ 9.5% Below SD avg. ▼ 9.5% Below SD avg.SD average: 3.3Click the badge to see the full State ranking.Click here to see the full State ranking.
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.
▼ 26.6% Below SD avg. ▼ 26.6% Below SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.

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 South Dakota state averages

Total nursing care / resident Info This home is ranked 37th 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.
3h 35m per day
Rank #37 / 65Nurse hours — State benchmarkedThis home is ranked 37th 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
This facility South Dakota avg (4h 20m per day)
vs South Dakota avg
-18%

4 of 6 metrics below state avg

Standout metric Registered Nurse (RN) is +44% above state 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. 1h 9m per day ▲ 44% State avg: 48m per day · National avg: 41m 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. 20m per day ▼ 30% State avg: 29m per day · National avg: 52m 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. 1h 58m per day ▼ 25% State avg: 2h 37m per day · National avg: 2h 21m 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 53m per day ▼ 13% State avg: 3h 19m per day · National avg: 3h 26m 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. 1m per day ▼ 52% State avg: 3m per day · National avg: 4m 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. 40m per day ▲ 30% State avg: 31m per day · National avg: 29m per day

Capacity and availability

Avg. Length of Stay
168 days
Bed community size
51-bed community Rank #66 / 117Bed count — State benchmarkedThis home is ranked 66th 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in 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.
Years in operation
1 year in operation Rank #14 / 51Years in operation — State benchmarkedThis home is ranked 14th out of 51 homes in South Dakota. Shows how long this facility has been in operation compared to other South Dakota facilities. Longer operating histories may benefit residents, families, and staff.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A newer community that may feature more recent facilities and programs.
Walk Score
Walk Score: 69 / 100 Rank #21 / 159Walk Score — State benchmarkedThis home is ranked 21st 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

About this community

Occupancy

Occupancy rate
90%
Rank #17 / 62Occupancy rate — State benchmarkedThis home is ranked 17th 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in 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 / 51
Average occupied beds in South Dakota homes 51 beds

License Details

Facility TypeNursing Home
StatusActive
IssuanceJanuary 7, 2025
ExpirationJune 30, 2026
CountyCodington
License Number10704

Ownership & Operating Entity

Avantara Watertown is administrated by Lynna Speier.

Therapy & Rehabilitation

2 services
Rehabilitation Services
Short-Term Rehab

Amenities & Lifestyle

Specific ProgramsStroke & Other Neurological Conditions, Cardiac Care, Oncology Recovery Care, Orthopedic Rehabilitation, Pulmonary Care

Contact Avantara Watertown

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

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.

Long-stay resident measures
Significantly below average South Dakota avg: 2.6 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.78
18% worse than South Dakota average

South Dakota average: 1.51

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 2.03
10% worse than South Dakota average

South Dakota average: 1.85

Short-stay resident measures
Below average South Dakota avg: 2.6 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 13.1%
39% better than South Dakota average

South Dakota average: 21.5%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 14.6%
25% worse than South Dakota average

South Dakota average: 11.7%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than South Dakota average

South Dakota average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 40.5%
25% worse than South Dakota average

South Dakota average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 41.8%
17% worse than South Dakota average

South Dakota average: 50.6%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

Breakdown by payment type

Medicare

62% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

27% of new residents, often for short stays.

Typical stay 7 - 8 months

Medicaid

11% of new residents, often for long-term daily care.

Typical stay 2 - 3 years

Finances and operations

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

Privately-owned community
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."
$5.1M
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."
$110.2K
Privately-owned community 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."
$5.1M Rank #30 / 63Revenue — State benchmarkedThis home is ranked 30th 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 %.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in 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."
$110.2K
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.
$45
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 #40 / 63Payroll — State benchmarkedThis home is ranked 40th 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$2.9M 57% 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 #52 / 63Payroll % — State benchmarkedThis home is ranked 52nd 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.Ranking totals vary by category as each rank only includes facilities that report data for that metric. Homes missing that data point aren't included in 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).
$2.1M
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).
$5.0M
How we calculate these figures

This home is administrated by Lynna Speier.

This home is owned by Lynna Speier

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 435068

Show certification details

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.

Most new residents arrive under Medicare (62% of admissions), and a typical Medicare stay runs around 1 - 2 months.

Admissions
93 total

Coverage residents most often arrive under.

Medicare 62%
Private pay 27%
Medicaid 11%
Discharges
100 total

Coverage residents most often leave under.

Medicare 32%
Private pay 33%
Medicaid 35%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

Avantara Watertown Reviews

Kayleen Thooft
The care my Mom received at Avantara was pathetic!!!

Places of interest near Avantara Watertown

Address 0.7 miles from city center Info Estimated distance in miles from Watertown's city center to Avantara Watertown's address, calculated via Google Maps. — 0.81 miles to nearest hospital (Prairie Lakes Hospital)

Calculate Travel Distance to Avantara Watertown

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Address

Compare Nursing Home around Watertown

The information below is reported by the South Dakota Department of Health, Office of Health Care Facilities Licensure.

2 facilities compared · CMS & SD Dept. of Health data

Avantara Watertown
NH
HC
MC
Watertown
51
Facility 51
SD AVG 69
Rank #66 / 117
90.2%
Facility 90.2%
SD AVG 79.9%
Rank #17 / 62
+13%
3.58
Facility 3.58
SD AVG 4.34
Rank #37 / 65
 +52%-18%
$6.4k
Facility $6.4k
SD AVG $38.5k
Rank #15 / 67
7
Facility 7
SD AVG 14.8
Rank #9 / 67
1.4
Facility 1.4
SD AVG 3.3
Rank #9 / 67
147-
85
Facility 85
SD AVG 39
Rank #1 / 159
Lynna Speier
$5.1M
Facility $5.1M
SD AVG $6.7M
Rank #30 / 63
$2.9M
Facility $2.9M
SD AVG $2.6M
Rank #40 / 63
57%
Facility 57%
SD AVG 40.8%
Rank #52 / 63
435068
Jenkin`s Living Center
NH
IL
MC
NC
Watertown
110
Facility 110
SD AVG 69
Rank #12 / 117
70.1%
Facility 70.1%
SD AVG 79.9%
Rank #45 / 62
-12%
4.44
Facility 4.44
SD AVG 4.34
Rank #19 / 65
 -20%+2%
$53.1k
Facility $53.1k
SD AVG $38.5k
Rank #52 / 67
25
Facility 25
SD AVG 14.8
Rank #53 / 67
4.2
Facility 4.2
SD AVG 3.3
Rank #48 / 67
371-
85
Facility 85
SD AVG 39
Rank #1 / 159
Doug Austin
$9.2M
Facility $9.2M
SD AVG $6.7M
Rank #8 / 63
$7.6M
Facility $7.6M
SD AVG $2.6M
Rank #8 / 63
82.4%
Facility 82.4%
SD AVG 40.8%
Rank #33 / 63
435036
Nursing Home Explorer

Financial Assistance for
Nursing Home in South Dakota

Avantara Watertown is located in Watertown, South Dakota.
Here are the financial assistance programs available to residents in South Dakota.

Get Financial aid guidance

Home and Community Based Services Waiver

SD Medicaid HCBS Waiver

Age 65+ or disabled
General South Dakota resident, Medicaid-eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
SD

Sparse population aids rural access; limited providers.

Benefits
Personal care (5-7 hours/day) Respite (240 hours/year) Adult day care (~$60/day) Home aides

South Dakota Elderly Services Program

SD ESP

Age 60+
General South Dakota resident, at risk of decline.
Income Limits ~$1,732/month individual, varies
Asset Limits $5,000 individual
SD

Limited funding; rural focus.

Benefits
In-home care (2-4 hours/week) Respite (up to 5 days/year) Transportation (~5 trips/month)

Medicare Savings Program (MSP)

South Dakota Medicare Savings Program

Age 65+ or disabled
General SD resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
SD

Three tiers; includes Extra Help for Part D; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Low-Income Home Energy Assistance Program (LIEAP)

South Dakota LIEAP

Age 60+ prioritized
General SD resident, low-income household.
Income Limits (2025) ~$3,970/month individual, 185% FPL
Asset Limits Not assessed; income-focused.
SD

Covers gas, electric, propane; weatherization add-on available.

Benefits
Heating/cooling aid ($300-$1,000/season) Emergency aid ($500 max)

Family Caregiver Support Program (FCSP)

South Dakota Family Caregiver Support Program

Age —
General Caregivers of 60+ needing care or 55+ caregivers of others; SD resident; functional needs (2+ ADLs).
Income Limits (2025) No strict cap; prioritizes low-income ~$24,980/year
Asset Limits Not assessed; need-based.
SD

Rural emphasis; includes grandparent caregivers.

Benefits
Respite (4-6 hours/week or 5 days/year) Adult day care ($60/day) Training Supplies (~$500/year)

VA Aid and Attendance (A&A) and Housebound Benefits

South Dakota VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General SD resident, wartime service, need for ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth limit
SD

Supports rural veterans; high demand near Sioux Falls VA.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living)

Property Tax Reduction Program

South Dakota Property Tax Reduction from Municipal Taxes

Age 65+ (or disabled) by Jan 1
General SD resident entire prior year, homeowner/renter.
Income Limits (2025) ~$20,192/year (single), ~$24,679/year (multiple-member household).
Asset Limits Not assessed; income-focused.
SD

Refunds up to $575; ~10,000 seniors benefit annually.

Benefits
Tax refund (~$250-$575/year based on income)

Senior Farmers’ Market Nutrition Program (SFMNP)

South Dakota SFMNP

Age 60+
General SD resident, low-income.
Income Limits (2025) ~$2,322/month individual, 185% FPL
Asset Limits Not assessed.
SD

Vouchers (~$50/season); serves ~5,000 annually via 6 AAAs.

Benefits
Vouchers (~$50/season) for fresh produce at approved markets

Freeze on Assessments for Dwellings of Disabled and Senior Citizens

South Dakota Property Tax Freeze

Age 65+ (or disabled)
General SD resident 200+ days prior year, homeowner.
Income Limits (2025) ~$35,000/year (single), ~$45,000/year (multiple-member household).
Asset Limits Property value < $250,000 (single), $300,000 (multiple).
SD

Saves ~$300-$600/year avg.; applies to primary residence.

Benefits
Assessment freeze (~$300-$600/year savings)

Older Americans Act (OAA) Services

South Dakota OAA Services

Age 60+
General SD resident (or spouse of any age); no income/asset limits.
Income Limits (2025) None; donations encouraged for some services.
Asset Limits Not assessed.
SD

6 AAAs; rural focus due to sparse population.

Benefits
Meals (home-delivered or congregate, ~$5-$7/meal value) Transportation Homemaker services (~4 hours/week) Respite (~5 days/year) Legal aid

Frequently Asked Questions about Avantara Watertown

What neighborhood is Avantara Watertown in?

Avantara Watertown is in the 4th Avenue Northeast neighborhood of Watertown.

Is Avantara Watertown in a walkable area?

Avantara Watertown has a walk score of 69. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

What is the license number of Avantara Watertown?

According to SD state health department records, Avantara Watertown's license number is 10704.

When does Avantara Watertown's license expire?

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

What is the occupancy rate at Avantara Watertown?

Avantara Watertown's occupancy is 90%.

Who is the administrator of Avantara Watertown?

Lynna Speier is the administrator of Avantara Watertown.

How many beds does Avantara Watertown have?

Avantara Watertown has 51 beds.

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