Avantara Milbank
Milbank, Grant County, South Dakota · CCN 435009 · For-profit (Corporation) · part of Legacy Healthcare (89 facilities, chain average 2.9 stars)
CMS rates Avantara Milbank 1 of 5 overall as of August 2026. 55 certified beds, 38 residents a day on average. 30 citations on record from the current inspection cycles, 8 involving actual harm; 3 fines totalling $55,361.
CMS’s ratings
The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.
| Overall | ★☆☆☆☆ 1 of 5 |
|---|---|
| Health inspections | ★☆☆☆☆ 1 of 5 |
| Staffing | ★★☆☆☆ 2 of 5 |
| Quality measures | ★★☆☆☆ 2 of 5 |
| Quality: long-stay / short-stay | 2 / — of 5 |
Staffing
| Total nurse staffing | 3.22996 hours per resident per day |
|---|---|
| Registered nurses | 0.96476 hours per resident per day |
| Weekend total | 2.93864 hours per resident per day |
| Nursing staff turnover | 91.5% (registered nurses 86.7%) |
| Administrators who left | 2 |
Citations from health inspections
Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.
| Survey | Finding | Severity | Status |
|---|---|---|---|
| 2026-05-07 complaint survey |
Ensure each resident must receive and the facility must provide necessary behavioral health care and services. Quality of Life and Care Deficiencies · tag F0740 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · tag F0550 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0602 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · tag F0684 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies · tag F0761 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · tag F0657 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. Quality of Life and Care Deficiencies · tag F0693 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2026-05-07 complaint survey |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · tag F0755 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-06 |
| 2025-03-13 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · tag F0812 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2025-04-21 |
| 2025-03-13 | Honor each resident's preferences, choices, values and beliefs. Quality of Life and Care Deficiencies · tag F0675 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-04-21 |
| 2025-03-13 complaint survey |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-04-21 |
| 2025-03-13 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · tag F0623 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-04-21 |
| 2025-03-13 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · tag F0625 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-04-21 |
| 2024-12-18 complaint survey |
Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2025-01-17 |
| 2024-12-18 complaint survey |
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · tag F0585 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-01-17 |
| 2024-12-18 complaint survey |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-01-17 |
| 2024-10-08 complaint survey |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2024-11-02 |
| 2024-10-08 complaint survey |
Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2024-11-02 |
| 2024-10-08 complaint survey |
Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · tag F0692 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2024-11-02 |
| 2024-08-06 complaint survey |
Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · tag F0677 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-10 |
| 2023-11-08 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2023-12-06 |
| 2023-11-08 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2023-12-06 |
| 2023-11-08 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · tag F0550 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-12-06 |
| 2023-11-08 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · tag F0656 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-12-06 |
| 2023-11-08 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-12-06 |
| 2022-09-01 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2022-10-21 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2024-12-18 | Fine | $28,912 |
| 2024-10-08 | Fine | $15,041 |
| 2023-11-08 | Fine | $11,408 |
Who owns and runs it
Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.
| Name | Role | Share | Since |
|---|---|---|---|
| Doros Generation Trust U/A/D 1/3/12 Organization | 5% or greater direct ownership interest | 43% | 2019-07-01 |
| Gpn Family Trust U/A/D 4/28/08 Organization | 5% or greater direct ownership interest | 43% | 2019-07-01 |
| Oakway Operations LLC Organization | 5% or greater direct ownership interest | 15% | 2019-07-01 |
| Milbank Sd Property Holdings, LLC Organization | 5% or greater security interest | — | 2019-07-01 |
| Truist Bank Organization | 5% or greater security interest | — | 2022-04-01 |
| Doros Generation Trust U/A/D 1/3/12 Organization | adp of the snf | — | 2019-07-01 |
| Gpn Family Trust U/A/D 4/28/08 Organization | adp of the snf | — | 2019-07-01 |
| Legacy Healthcare Financial Services LLC Organization | adp of the snf | — | 2019-07-01 |
| Milbank Sd Property Holdings, LLC Organization | adp of the snf | — | 2019-07-01 |
| Rsm US LLP Organization | adp of the snf | — | 2024-01-01 |
| Truist Bank Organization | operational/managerial control | — | 2022-04-01 |
| Eggers, Austin Individual | adp of the snf | — | 2025-01-01 |
| Pulse, Rebecca Individual | adp of the snf | — | 2024-01-02 |
| Rajchenbach, Chaim Individual | adp of the snf | — | 2019-07-01 |
| Shabat, Menachem Individual | adp of the snf | — | 2019-07-01 |
| Rajchenbach, Chaim Individual | managing control - governing body | — | 2019-07-01 |
| Shabat, Menachem Individual | managing control - governing body | — | 2019-07-01 |
| Eggers, Austin Individual | operational/managerial control | — | 2025-01-01 |
| Pulse, Rebecca Individual | operational/managerial control | — | 2024-01-02 |
| Rajchenbach, Chaim Individual | operational/managerial control | — | 2019-07-01 |
| Shabat, Menachem Individual | operational/managerial control | — | 2019-07-01 |
What changed
Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.
Tell me when this record changes
One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for Avantara Milbank.
Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Grant County.