Avantara Arrowhead
Rapid City, Pennington County, South Dakota · CCN 435051 · For-profit (LLC) · part of Legacy Healthcare (89 facilities, chain average 2.9 stars)
CMS rates Avantara Arrowhead 1 of 5 overall as of August 2026. 68 certified beds, 59 residents a day on average. 45 citations on record from the current inspection cycles, 10 involving actual harm; 6 fines totalling $153,583.
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.
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 | 1 / 2 of 5 |
Staffing
| Total nurse staffing | 3.52278 hours per resident per day |
|---|---|
| Registered nurses | 0.98352 hours per resident per day |
| Weekend total | 3.26944 hours per resident per day |
| Nursing staff turnover | 76.1% (registered nurses 75%) |
| 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 |
|---|---|---|---|
| 2026-06-22 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 2026-03-27 |
| 2026-06-22 complaint survey |
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Administration Deficiencies · tag F0867 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has plan of correction 2026-08-04 |
| 2026-06-22 | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · tag F0554 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has plan of correction 2026-08-04 |
| 2026-06-22 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 |
E No actual harm, with potential for more than minimal harm; pattern | Past Non-Compliance 2026-04-19 |
| 2026-06-22 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 | Past Non-Compliance 2026-06-15 |
| 2026-06-22 | 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 plan of correction 2026-08-04 |
| 2026-06-22 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 | Past Non-Compliance 2026-06-12 |
| 2026-06-22 | 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 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has plan of correction 2026-08-04 |
| 2026-06-22 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · tag F0695 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has plan of correction 2026-08-04 |
| 2025-12-10 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 |
| 2025-12-10 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 | Past Non-Compliance |
| 2025-12-10 complaint survey |
Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · tag F0697 |
D No actual harm, with potential for more than minimal harm; isolated | Past Non-Compliance |
| 2025-11-06 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 2025-12-06 |
| 2025-09-11 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 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · tag F0759 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · tag F0554 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · tag F0583 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies · tag F0645 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | 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 2025-10-15 |
| 2025-09-11 | Provide care or services that was trauma informed and/or culturally competent. Quality of Life and Care Deficiencies · tag F0699 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | Provide medically-related social services to help each resident achieve the highest possible quality of life. Quality of Life and Care Deficiencies · tag F0745 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-09-11 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · tag F0842 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-10-15 |
| 2025-06-18 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-07-18 |
| 2025-06-18 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 2025-07-18 |
| 2025-06-18 complaint survey |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · tag F0580 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-07-18 |
| 2025-03-26 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 2025-03-25 |
| 2025-03-26 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 2025-04-30 |
| 2025-03-05 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 2025-03-04 |
| 2025-03-05 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 | Past Non-Compliance 2025-03-04 |
| 2025-03-05 complaint survey |
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. Quality of Life and Care Deficiencies · tag F0678 |
D No actual harm, with potential for more than minimal harm; isolated | Past Non-Compliance 2025-03-04 |
| 2024-08-06 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 | Deficient, Provider has date of correction 2024-08-22 |
| 2024-07-10 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 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2024-08-03 |
| 2024-07-10 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 2024-06-21 |
| 2024-05-15 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · tag F0690 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2024-06-13 |
| 2024-05-15 | 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 2024-06-13 |
| 2024-05-15 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-06-13 |
| 2024-05-15 | 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 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-06-13 |
| 2024-05-15 | 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 2024-06-13 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2025-11-06 | Fine | $70,720 |
| 2025-09-11 | Fine | $42,705 |
| 2025-03-05 | Fine | $8,112 |
| 2024-07-10 | Fine | $11,333 |
| 2024-07-10 | Fine | $8,018 |
| 2024-05-15 | Fine | $12,695 |
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 |
| Arrowhead Sd Property Holdings, LLC Organization | 5% or greater security interest | — | 2019-07-01 |
| Truist Bank Organization | 5% or greater security interest | — | 2022-04-01 |
| Arrowhead Sd Property Holdings, LLC Organization | adp of the snf | — | 2019-07-01 |
| 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 | — | 2025-11-10 |
| Rsm US LLP Organization | adp of the snf | — | 2024-01-01 |
| Legacy Healthcare Financial Services LLC Organization | operational/managerial control | — | 2019-07-01 |
| Truist Bank Organization | operational/managerial control | — | 2022-04-01 |
| Martin, Sharon Individual | adp of the snf | — | 2023-04-09 |
| Ptacek, Travis Individual | adp of the snf | — | 2025-01-01 |
| 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 |
| Martin, Sharon Individual | operational/managerial control | — | 2023-04-09 |
| Ptacek, Travis Individual | operational/managerial control | — | 2025-01-01 |
| 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 Arrowhead.
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 Pennington County.