Avantara Norton

Name: Avantara Norton: CMS nursing home record
Creator: Centers for Medicare & Medicaid Services
License: https://www.usa.gov/government-works

Sioux Falls, Minnehaha County, South Dakota · CCN 435039 · For-profit (LLC) · part of Legacy Healthcare (89 facilities, chain average 2.9 stars)

CMS rates Avantara Norton unrated overall as of August 2026. 110 certified beds, 98 residents a day on average. 75 citations on record from the current inspection cycles, 1 at immediate jeopardy; 7 fines totalling $215,483.

On record

Abuse icon. CMS marks this facility for a citation of abuse that led to harm, or a repeated potential for it, within the recent inspection cycles.
Special Focus Facility. CMS has placed this facility in the program for homes with a history of serious quality issues, which brings more frequent inspection.

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	Did not submit staffing data, or submitted data that did not meet the criteria for a staffing rating (CMS footnote 18)
Health inspections	Did not submit staffing data, or submitted data that did not meet the criteria for a staffing rating (CMS footnote 18)
Staffing	Did not submit staffing data, or submitted data that did not meet the criteria for a staffing rating (CMS footnote 18)
Quality measures	Did not submit staffing data, or submitted data that did not meet the criteria for a staffing rating (CMS footnote 18)

Staffing

Total nurse staffing	3.8558 hours per resident per day
Registered nurses	0.76616 hours per resident per day
Weekend total	3.45306 hours per resident per day
Nursing staff turnover	55.7% (registered nurses 50%)
Administrators who left	0

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
2026-03-31 complaint survey	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · tag F0684	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31 complaint survey	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31 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	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31	Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · tag F0697	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31	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 2026-05-08
2026-03-31 complaint survey	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Resident Rights Deficiencies · tag F0561	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2026-05-08
2026-03-31	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2026-05-08
2026-03-31	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · tag F0655	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2026-05-08
2026-03-31 complaint survey	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. Quality of Life and Care Deficiencies · tag F0688	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2026-05-08
2026-03-31 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	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · tag F0578	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31 complaint survey	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31 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	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance 2025-12-10
2026-03-31	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	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2026-05-08
2026-03-31	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 2026-05-08
2026-02-04 complaint survey	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · tag F0684	G Actual harm that is not immediate jeopardy; isolated	Past Non-Compliance 2026-01-16
2026-02-04 complaint survey	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-03-06
2026-02-04 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	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2026-03-06
2025-12-30 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	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance
2025-12-30 complaint survey	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · tag F0804	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance
2025-11-14 complaint survey	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 2025-12-12
2025-07-10 complaint survey	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686	G Actual harm that is not immediate jeopardy; isolated	Past Non-Compliance 2025-05-01
2025-07-10 complaint survey	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance 2025-05-28
2025-07-10 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 2025-08-04
2025-07-10 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	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance 2025-06-07
2025-04-10 complaint survey	Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · tag F0658	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction
2025-04-10 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	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance 2025-04-09
2025-04-10 complaint survey	Prepare residents for a safe transfer or discharge from the nursing home. Resident Rights Deficiencies · tag F0624	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction
2025-03-05 complaint survey	Honor each resident's preferences, choices, values and beliefs. Quality of Life and Care Deficiencies · tag F0675	H Actual harm that is not immediate jeopardy; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Resident Rights Deficiencies · tag F0582	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · tag F0695	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	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	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	Administer the facility in a manner that enables it to use its resources effectively and efficiently. Administration Deficiencies · tag F0835	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. Administration Deficiencies · tag F0837	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2025-04-04
2025-03-05	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 2025-04-04
2025-03-05	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 2025-04-04
2025-03-05	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 2025-04-04
2024-12-27 complaint survey	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · tag F0684	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2025-02-10
2024-11-14 complaint survey	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2024-12-11
2024-10-29 complaint survey	Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · tag F0726	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2024-11-27
2024-10-29 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 2024-11-27
2024-09-26 complaint survey	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · tag F0655	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2024-11-10
2024-08-21 complaint survey	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2024-09-20
2024-08-21 complaint survey	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2024-09-20
2024-08-21 complaint survey	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · tag F0804	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2024-09-20
2024-07-17 complaint survey	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 2024-08-26
2024-06-20 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	G Actual harm that is not immediate jeopardy; isolated	Past Non-Compliance 2024-05-30
2024-06-20 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	Past Non-Compliance 2024-05-30
2024-04-16 complaint survey	Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · tag F0726	D No actual harm, with potential for more than minimal harm; isolated	Past Non-Compliance 2024-04-14
2024-03-13 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	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2024-04-08
2024-03-13 complaint survey	Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · tag F0697	G Actual harm that is not immediate jeopardy; isolated	Deficient, Provider has date of correction 2024-04-08
2024-03-13 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 2024-04-08
2023-12-14 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	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2024-01-11
2023-12-14 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 2024-01-11
2023-11-09 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	K Immediate jeopardy to resident health or safety; pattern	Deficient, Provider has plan of correction 2023-12-07
2023-11-09	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686	H Actual harm that is not immediate jeopardy; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · tag F0725	H Actual harm that is not immediate jeopardy; pattern	Deficient, Provider has plan of correction 2023-12-07
2023-11-09 complaint survey	Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · tag F0726	H Actual harm that is not immediate jeopardy; pattern	Deficient, Provider has plan of correction 2023-12-07
2023-11-09	Administer the facility in a manner that enables it to use its resources effectively and efficiently. Administration Deficiencies · tag F0835	F No actual harm, with potential for more than minimal harm; widespread	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. Administration Deficiencies · tag F0837	F No actual harm, with potential for more than minimal harm; widespread	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Resident Rights Deficiencies · tag F0561	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Honor the resident's right to organize and participate in resident/family groups in the facility. Resident Rights Deficiencies · tag F0565	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	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	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	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	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09 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	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · tag F0692	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · tag F0756	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Pharmacy Service Deficiencies · tag F0758	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Nutrition and Dietary Deficiencies · tag F0802	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. Nutrition and Dietary Deficiencies · tag F0809	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-11-09	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 2023-12-14
2023-11-09	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 2023-12-14
2023-11-09	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 2023-12-14
2023-10-04 complaint survey	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Resident Rights Deficiencies · tag F0584	E No actual harm, with potential for more than minimal harm; pattern	Deficient, Provider has date of correction 2023-12-14
2023-10-04 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	D No actual harm, with potential for more than minimal harm; isolated	Deficient, Provider has date of correction 2023-12-14

Fines and payment denials

Date	Penalty	Amount
2026-02-04	Fine	$61,845
2025-03-05	Fine	$51,376
2024-09-26	Fine	$12,035
2024-07-17	Fine	$12,035
2024-06-20	Fine	$12,035
2024-03-13	Fine	$37,557
2023-10-04	Fine	$28,600

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%	2019-10-02
Gpn Family Trust U/A/D 4/28/08 Organization	5% or greater direct ownership interest	43%	2019-10-02
Oakway Operations LLC Organization	5% or greater direct ownership interest	15%	2019-10-02
Bokf,Na Organization	5% or greater security interest	—	2024-03-04
Norton Sd Property Holdings, LLC Organization	5% or greater security interest	—	2019-10-02
Doros Generation Trust U/A/D 1/3/12 Organization	adp of the snf	—	2019-10-02
Gpn Family Trust U/A/D 4/28/08 Organization	adp of the snf	—	2019-10-02
Legacy Healthcare Financial Services LLC Organization	adp of the snf	—	2025-11-24
Norton Sd Property Holdings, LLC Organization	adp of the snf	—	2019-10-02
Roth & Co, LLP Organization	adp of the snf	—	2024-01-01
Bokf,Na Organization	operational/managerial control	—	2024-03-04
Legacy Healthcare Financial Services LLC Organization	operational/managerial control	—	2019-10-02
Nickel, Ashley Individual	adp of the snf	—	2022-08-28
Rees, Joseph Individual	adp of the snf	—	2019-10-02
Shabat, Menachem Individual	adp of the snf	—	2019-10-02
Shabat, Menachem Individual	managing control - governing body	—	2019-10-02
Nickel, Ashley Individual	operational/managerial control	—	2022-08-28
Rees, Joseph Individual	operational/managerial control	—	2019-10-02
Shabat, Menachem Individual	operational/managerial control	—	2019-10-02

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 Norton.

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 Minnehaha County.