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Avantara Watertown
Nursing Home, Hospice Care, Memory Care & Skilled Nursing · 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 Cozy shared resident room with twin beds and decor.

Avantara Watertown

Nursing Home, Hospice Care, Memory Care & Skilled Nursing · 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
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Avantara Watertown accepts Medicare, Medicaid, and private pay.
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Avantara Watertown accepts Medicare, Medicaid, and private pay.

Overview of Avantara Watertown

LinkedIn

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.

Facility Direct Line (605) 886-8431
LinkedIn

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.
▼ 63.2% Below SD avg. ▼ 63.2% Below 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.
▼ 63.0% Below SD avg. ▼ 63.0% Below 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 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 vs South Dakota averages

Rank #58 / 65Nurse hours — State benchmarkedThis nursing home is ranked 58th out of 65 nursing homes we track in South Dakota for nurse hours. 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.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This nursing home is ranked 58th out of 65 nursing homes we track 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 2m

30% below state avg
Staff type
Hours / day / resident
vs 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.
54m
−3% State avg: 56m per day · National avg: 42m 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.
21m
−35% State avg: 32m 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 47m
−39% State avg: 2h 56m per day · National avg: 2h 24m 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 27m
−34% State avg: 3h 43m per day · National avg: 3h 31m 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
−60% 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.
34m
+6% State avg: 32m per day · National avg: 29m per day

5 of 6 metrics below state avg

Standout metric: Weekend RN is +6% above South Dakota average

By The Numbers

Community insights.

Bed count Info A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions. 51 Rank #43 / 70Bed count — State benchmarkedThis nursing home is ranked 43rd out of 70 nursing homes we track in South Dakota for bed count. 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.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Smaller home · May offer a more intimate, personalized care environment.

Years of operating Info A newer community that may feature more recent facilities and programs. This is the number of years in operation under current management. Rank #3 / 64Years in operation — State benchmarkedThis nursing home is ranked 3rd out of 64 nursing homes we track in South Dakota for years in operation. Shows how long this facility has been in operation compared to other South Dakota facilities. Longer operating histories may benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
1 year
Walk Score Info Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities. Rank #11 / 73Walk Score — State benchmarkedThis nursing home is ranked 11th out of 73 nursing homes we track in South Dakota for walk score. 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.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
69 / 100
Residents per day (avg) Info The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
47
Avg. Length of Stay Info 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.
168 days

About this community

License Details

Facility TypeNursing Home
IssuanceJanuary 7, 2025
CountyCodington
License Number10704

Ownership & Operating Entity

Avantara Watertown is administered by Lynna Speier.

Therapy & Rehabilitation

2 services
Rehabilitation Services
Short-Term Rehab

Additional Policies & Features

Pets not allowed

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.

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.

For-profit
Operated by a limited liability company.
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
For-profit Operated by a limited liability company.
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 #34 / 58Net patient revenue — State benchmarkedThis nursing home is ranked 34th out of 58 nursing homes we track in South Dakota. Shows this facility's net patient revenue compared to the South Dakota average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
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 #35 / 58Payroll costs — State benchmarkedThis nursing home is ranked 35th out of 58 nursing homes we track in South Dakota. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the South Dakota average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
$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 #21 / 58Payroll % of net patient revenue — State benchmarkedThis nursing home is ranked 21st out of 58 nursing homes we track in South Dakota. Shows payroll as a percentage of net patient revenue versus the South Dakota average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in South Dakota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
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 administered 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
Reviews (1)

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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Financial Assistance for
Nursing Home in South Dakota

Avantara Watertown is located in NE 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

Is Avantara Watertown in a walkable area?

Avantara Watertown has a walk score of 69. Somewhat 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.

What is the occupancy rate at Avantara Watertown?

Avantara Watertown's occupancy is 90.2%.

How long has Avantara Watertown been in business?

Avantara Watertown has been operating for approximately 1 year, based on available licensing and registration records.

Are pets allowed at Avantara Watertown?

No, Avantara Watertown has a no-pet policy.

Does Avantara Watertown operate as a for-profit or non-profit?

Avantara Watertown is registered as a for-profit in SD.

Who is the administrator of Avantara Watertown?

Lynna Speier is the administrator of Avantara Watertown.

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