Avantara Watertown
Watertown, Codington County, South Dakota · CCN 435068 · For-profit (LLC) · part of Legacy Healthcare (89 facilities, chain average 2.9 stars)
CMS rates Avantara Watertown 1 of 5 overall as of August 2026. 51 certified beds, 47 residents a day on average. 32 citations on record from the current inspection cycles, 2 at immediate jeopardy; 1 fine totalling $6,368.
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 candidate. On CMS’s list of facilities that qualify for the program but are not yet in it.
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 | ★★★☆☆ 3 of 5 |
| Quality measures | ★★☆☆☆ 2 of 5 |
| Quality: long-stay / short-stay | 2 / 3 of 5 |
Staffing
| Total nurse staffing | 3.5691 hours per resident per day |
|---|---|
| Registered nurses | 1.06392 hours per resident per day |
| Weekend total | 2.87012 hours per resident per day |
| Nursing staff turnover | 44.2% (registered nurses 27.3%) |
| Administrators who left | 1 |
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 |
|---|---|---|---|
| 2026-06-17 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 plan of correction 2026-08-01 |
| 2026-04-29 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 date of correction 2026-06-02 |
| 2026-04-29 | 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 |
J Immediate jeopardy to resident health or safety; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 | Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · tag F0583 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 complaint survey |
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 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 | Have a plan that describes the process for conducting QAPI and QAA activities. Administration Deficiencies · tag F0865 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 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 2026-06-02 |
| 2026-04-29 | 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. Quality of Life and Care Deficiencies · tag F0700 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · tag F0552 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. Resident Rights Deficiencies · tag F0628 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · tag F0644 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 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 2026-06-02 |
| 2026-04-29 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · tag F0759 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2026-04-29 | 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 2026-06-02 |
| 2026-04-29 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · tag F0806 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-06-02 |
| 2025-03-06 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 | Past Non-Compliance 2025-02-28 |
| 2024-12-05 | 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 2025-01-06 |
| 2024-12-05 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 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-01-06 |
| 2024-12-05 | 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 2025-01-06 |
| 2024-03-19 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 2024-04-24 |
| 2023-09-28 | 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 2023-11-06 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2025-03-06 | Fine | $6,368 |
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 |
| Truist Bank Organization | 5% or greater security interest | — | 2022-04-01 |
| Watertown Sd Property Holdings, LLC Organization | 5% or greater security interest | — | 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 | — | 2019-07-01 |
| Rsm US LLP Organization | adp of the snf | — | 2024-01-01 |
| Watertown Sd Property Holdings, LLC Organization | adp of the snf | — | 2019-07-01 |
| Truist Bank Organization | operational/managerial control | — | 2022-04-01 |
| Rajchenbach, Chaim Individual | adp of the snf | — | 2019-07-01 |
| Shabat, Menachem Individual | adp of the snf | — | 2019-07-01 |
| Shives, Aaron Individual | adp of the snf | — | 2019-07-01 |
| Speier, Lynna Individual | adp of the snf | — | 2025-10-01 |
| Rajchenbach, Chaim Individual | managing control - governing body | — | 2019-07-01 |
| Shabat, Menachem Individual | managing control - governing body | — | 2019-07-01 |
| Rajchenbach, Chaim Individual | operational/managerial control | — | 2019-07-01 |
| Shabat, Menachem Individual | operational/managerial control | — | 2019-07-01 |
| Shives, Aaron Individual | operational/managerial control | — | 2019-07-01 |
| Speier, Lynna Individual | operational/managerial control | — | 2025-10-01 |
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 Watertown.
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 Codington County.