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Nursing Home in South Dakota

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.

Avantara Watertown

Nursing Home in South Dakota

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.

Avantara Watertown

Overview of Avantara Watertown

Avantara Watertown is 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 rehabilitative homes, there is a merit of an incomparable level of care that provoke quality service delivered by only the best team of professionals who offer tailored personal care plans for each unique individual; with that merit comes a two-time recognition as the ‘Best Nursing Homes – Long-Term Care’ by the U.S. News and World Report. Avantara Watertown 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; cardiac care, bariatric care, G-tube, IV therapy, orthopedic care, oncology care, stroke recovery, wound care, and memory care. The list of accommodations extends to the comprehensive care plan physical therapy equipment, a team of  full-time therapists on-site, and a home assessment completed. 

(605) 886-8431

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.
2/5
South Dakota average: 2.5/5
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.
3/5
South Dakota average: 2.6/5
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.
4/5
South Dakota average: 2.9/5
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.
1/5
South Dakota average: 2.7/5

Nursing care per resident

Info This shows how many total hours of nursing staff time are available per resident each day. Higher numbers usually mean more staff support.
3h 35m per day

This home provides 5% less nursing time per resident than the South Dakota average.

South Dakota average: 3h 46m per day

Staffing hours breakdown

Info Hours of care per resident per day, broken down by staff type. Data from CMS Medicare.
Staff type Facility State avg National avg
Registered Nurse (RN) Info Registered nurse hours per resident per day. 1h 10m per day 48m per day 41m per day
Nurse Aide Info Nurse aide hours per resident per day. 2h 11m per day 2h 37m per day 2h 21m per day
Total Nursing (Weekend) Info Total number of nurse staff hours per resident per day on weekends. 3h 1m per day 3h 19m per day 3h 26m per day
Physical Therapist Info Physical therapist staff hours per resident per day. 2m per day 3m per day 4m per day
RN (Weekend) Info Registered nurse hours per resident per day on weekends. 45m per day 31m per day 29m per day

Capacity and availability

Smaller home

May offer a more intimate, personalized care environment.

Total beds 51

This home usually has limited availability

Occupancy is moderate, suggesting balanced demand.

Similar demand to the South Dakota average: 79.9%
Occupancy rate 90.2%
Residents per day (avg) 46
Occupancy rate
90.2%
Residents per day (avg)
46

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.

Might be optimal for
Short stays Recovery Medicare-covered care

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

Privately-owned community
Operated by a business corporation.
Home revenue
$7.9M
Profit
$110.2K
Privately-owned community Operated by a business corporation.
Home revenue
$7.9M
Profit
$110.2K
Payroll costs Info The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
$2.4M
30.8% of revenue
Other operating costs Info All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$5.4M
Total costs $7.8M
Bed community size
51-bed community
A moderately sized community that may balance personal attention with shared amenities and social activities.
Years in operation
1 year in operation
A newer community that may feature more recent facilities and programs.
Walk Score
Walk Score: 69 / 100
Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

About this community

Occupancy

Occupancy rate
90%
In line with South Dakota average
Occupied beds
46 / 51
Average residents 51 per day

License Details

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

Additional Licensing Details

License Number10704

Ownership & Operating Entity

Avantara Watertown is administrated by Speier, Lynna.

Therapy & Rehabilitation

2 services
Rehabilitation Services
Short-Term Rehab

Amenities & Lifestyle

0 amenities
Specific ProgramsShort-Term Rehabilitation, Stroke & Other Neurological Conditions, Cardiac Care, Oncology Recovery Care, Wound Care, Orthopedic Rehabilitation, Pulmonary Care

Contact Avantara Watertown

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.

5 visits/inspections Info 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.

Latest inspection

Date March 6, 2025
Complaint Investigation

10 deficiencies

Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.

South Dakota average: 19 deficiencies

Inspection Report Summary for Avantara Watertown

The most recent inspection on March 6, 2025, identified a deficiency related to a medication error that resulted in acute kidney injury for one resident. Earlier inspections showed a pattern of medication management issues, including problems with fentanyl patch accountability and expired medications, as well as concerns about resident dignity and oral care documentation. Complaint investigations in December 2024 and March 2025 were substantiated, focusing on medication errors and controlled substance monitoring. No fines, immediate jeopardy findings, or license actions were listed in the available reports. The facility’s inspection history indicates ongoing challenges with medication management, with corrective actions implemented after each finding.

Health Inspection History

Inspections
Total health inspections 5

South Dakota average 4.5


Last Health inspection on Mar 2025

Total health citations 7

South Dakota average 14.8

Citations per inspection
1.4

South Dakota average 3.34


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

4 of 7 citations resulted from standard inspections; 2 of 7 resulted from complaint investigations; and 1 of 7 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 3 years)
Critical Health citations More info 0
100% better than South Dakota average

South Dakota average: 0.3


Serious Health citations More info 1
44% better than South Dakota average

South Dakota average: 1.8

0 critical citations More info South Dakota average: 0.3

1 serious citation More info South Dakota average: 1.8

6 moderate citations More info South Dakota average: 12.6

0 minor citations More info South Dakota average: 0
Citations history (last 3 years)
Pharmacy serious citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Mar 06, 2025
Corrected

Pharmacy moderate citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Dec 05, 2024
Corrected

Pharmacy moderate citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Dec 05, 2024
Corrected

Resident Rights moderate citation Info Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care. Dec 05, 2024
Corrected

Compare Nursing Homes around Watertown The information below is reported by the South Dakota Department of Health, Office of Health Care Facilities Licensure.

5 facilities compared · CMS & SD Dept. of Health data · Updated Apr 2026

Filter by care type
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.

Alcester39 94.9% +19%3.72 +30%-14%2112.2137--Stroschein Properties Iii Llc$2.9M$1.5M51.8%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 (Clark)38 79.4% -1%3.15 -22%-27%151.3131- 31 Schlomer, Tiffany$6.0M$1.5M25.5%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 Lake44 61.7% -23%3.45 +29%-20%2163.2140--Aurora-Brule Nursing Home$2.8M$1.5M52.4%435132
Avantara Watertown
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.

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).

Watertown (4Th Avenue Northeast)51 90.2% +13%3.58 +27%-18%171.4146- 69 Speier, Lynna$7.9M$2.4M30.8%435068
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)74 75.2% -6%2.80 +52%-36%5343.8961- 12 Preston, Philip$10.7M$2.9M27.3%435051

Avantara Watertown Reviews

Share your thoughts and experiences about Avantara Watertown. Let’s celebrate the stories that make a difference!
Reviewer avatar
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. — 0.75 miles to nearest hospital (Prairie Lakes Specialty Clinic)

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Staffing Data (Q2 2025)

This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.

Total staff 80
Employees 59
Contractors 21
Staff to resident ratio 1.86:1
0% compared with South Dakota average

South Dakota average ratio: 1.91:1

Avg staff/day 28
Average shift 7.4 hours
0% compared with South Dakota average

South Dakota average: 7.7 hours

Total staff hours (quarter) 18,916
Nursing staff breakdown
Registered Nurse

Manages medical care and health needs.

Total count 11
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.7 hours

No contractors work on this role.

Licensed Practical Nurse

Assists with medical care and medications.

Total count 10
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.6 hours

This role is partially covered by contractors.

Certified Nursing Assistant

Helps with daily care and mobility.

Total count 31
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.7 hours

No contractors work on this role.

Contractor staffing

Total hours from contractors

7.1%

1,342 contractor hours this quarter

Physical Therapy Aide: 6 Respiratory Therapy Technician: 5 Speech Language Pathologist: 3 Physical Therapy Assistant: 3 Licensed Practical Nurse: 3 Qualified Social Worker: 1
Staff by category
Certified Nursing Assistant310319,20991100%7.7
Registered Nurse110113,0989099%8.7
Licensed Practical Nurse73101,5588492%9.6
Clinical Nurse Specialist3031,3466571%8.1
Other Dietary Services Staff30357591100%4.8
Administrator1015126470%8
Dietitian1014725965%8
Physical Therapy Aide0664667380%4.7
Nurse Practitioner1014645864%8
Mental Health Service Worker1014325459%8
Speech Language Pathologist0334107077%5.1
Qualified Social Worker0111616066%2.7
Respiratory Therapy Technician0551344347%3.1
Physical Therapy Assistant033794752%1.5
31 Certified Nursing Assistant
% of Days 100%
11 Registered Nurse
% of Days 99%
10 Licensed Practical Nurse
% of Days 92%
3 Clinical Nurse Specialist
% of Days 71%
3 Other Dietary Services Staff
% of Days 100%
1 Administrator
% of Days 70%
1 Dietitian
% of Days 65%
6 Physical Therapy Aide
% of Days 80%
1 Nurse Practitioner
% of Days 64%
1 Mental Health Service Worker
% of Days 59%
3 Speech Language Pathologist
% of Days 77%
1 Qualified Social Worker
% of Days 66%
5 Respiratory Therapy Technician
% of Days 47%
3 Physical Therapy Assistant
% of Days 52%

Facility Characteristics

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

Total residents 43
Medicare
7
16.3% of residents
Medicaid
24
55.8% of residents
Private pay or other
12
27.9% 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.

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. 12.8
6% worse than South Dakota average

South Dakota average: 12.0

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 29.4
23% worse than South Dakota average

South Dakota average: 23.9

Long-stay resident measures
Significantly below average South Dakota avg: 2.5 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 21.3%
5% better than South Dakota average

South Dakota average: 22.3%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 35.4%
55% worse than South Dakota average

South Dakota 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 31.6%
18% worse than South Dakota average

South Dakota average: 26.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 1.4%
73% better than South Dakota average

South Dakota average: 5.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 3.4%
24% better than South Dakota average

South Dakota average: 4.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 6.3%
81% worse than South Dakota average

South Dakota average: 3.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 2.3%
57% better than South Dakota average

South Dakota average: 5.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 6.5%
59% worse than South Dakota average

South Dakota average: 4.1%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 10.8%
56% better than South Dakota average

South Dakota average: 24.4%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 88.4%
8% worse than South Dakota average

South Dakota average: 95.7%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 94.9%
In line with South Dakota average

South Dakota average: 96.9%

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: 2.9 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 77.6%
8% worse than South Dakota average

South Dakota average: 84.4%

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

South Dakota average: 1.8%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 42.9%
45% worse than South Dakota average

South Dakota average: 78.2%

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%

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 $13K
68% lower than South Dakota average

South Dakota average: $40K

Number of fines 1
51% fewer fines than South Dakota average

South Dakota 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 South Dakota average

South Dakota average: 0.0

Fines amount comparison
Fines amount comparison
This facility $13K
South Dakota average $40K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Mar 6, 2025
$13K

Last updated: Jan 2026

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Financial Aid for South Dakota Seniors

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Home and Community Based Services Waiver

SD Medicaid HCBS Waiver

Age 65+ or disabled, South Dakota resident, Medicaid-eligible, nursing home-level care need.

~$2,829/month (300% FBR, individual).

$2,000 (individual), $3,000 (couple).

Sparse population aids rural access; limited providers.

South Dakota Elderly Services Program

SD ESP

Age 60+, South Dakota resident, at risk of decline.

~$1,732/month (individual, varies).

$5,000 (individual).

Limited funding; rural focus.

Medicare Savings Program (MSP)

South Dakota Medicare Savings Program

Age 65+ or disabled, SD resident, Medicare Part A/B.

~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.

$9,430 (individual), $14,130 (couple).

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

Low-Income Home Energy Assistance Program (LIEAP)

South Dakota LIEAP

Age 60+ prioritized, SD resident, low-income household.

~$3,970/month (individual, 185% FPL).

Not assessed; income-focused.

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

Family Caregiver Support Program (FCSP)

South Dakota Family Caregiver Support Program

Caregivers of 60+ needing care or 55+ caregivers of others; SD resident; functional needs (2+ ADLs).

No strict cap; prioritizes low-income (~$24,980/year).

Not assessed; need-based.

Rural emphasis; includes grandparent caregivers.

Senior Community Service Employment Program (SCSEP)

South Dakota SCSEP

Age 55+, unemployed, low-income, SD resident.

~$1,983/month (125% FPL).

Not specified; income-focused.

Priority for veterans, rural residents; AARP partnership.

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

South Dakota VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse, SD resident, wartime service, need for ADL help (A&A) or homebound.

Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.

~$155,356 (net worth limit).

Supports rural veterans; high demand near Sioux Falls VA.

Property Tax Reduction Program

South Dakota Property Tax Reduction from Municipal Taxes

Age 65+ (or disabled) by Jan 1, SD resident entire prior year, homeowner/renter.

~$20,192/year (single), ~$24,679/year (multiple-member household).

Not assessed; income-focused.

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

Senior Farmers’ Market Nutrition Program (SFMNP)

South Dakota SFMNP

Age 60+, SD resident, low-income.

~$2,322/month (individual, 185% FPL).

Not assessed.

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

Freeze on Assessments for Dwellings of Disabled and Senior Citizens

South Dakota Property Tax Freeze

Age 65+ (or disabled), SD resident 200+ days prior year, homeowner.

~$35,000/year (single), ~$45,000/year (multiple-member household).

Property value < $250,000 (single), $300,000 (multiple).

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

Older Americans Act (OAA) Services

South Dakota OAA Services

Age 60+, SD resident (or spouse of any age); no income/asset limits.

None; donations encouraged for some services.

Not assessed.

6 AAAs; rural focus due to sparse population.

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