Cycle 1
Health 2026-01-08 · Fire 2026-01-08
4 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
4 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Clark, SD
Avantara Clark City
4-star overall rating with 4-star inspections with $11,057 in total fines with 4 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
201 8th Avenue Nw, Clark, SD
(605) 532-3431
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
35
Certified beds
Average residents
29
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Legacy Healthcare
Operator or chain grouping
Approved since
1991-05-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
90 facilities
Chain averages 3 overall / 3 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.78
Registered nurse staffing · state 0.80 · national 0.68
LPN hours / resident day
0.58
Licensed practical nurse staffing · state 0.49 · national 0.87
Aide hours / resident day
2.62
Nurse aide staffing · state 2.61 · national 2.35
Total nurse hours
3.98
All reported nurse hours · state 3.89 · national 3.89
Licensed hours
1.36
RN + LPN hours · state 1.28 · national 1.54
Weekend hours
3.40
Weekend nurse staffing · state 3.32 · national 3.43
Weekend RN hours
0.57
Weekend registered nurse coverage · state 0.51 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.64
CMS adjusted RN staffing hours
Adjusted total hours
3.25
CMS adjusted total nurse staffing hours
Case-mix index
1.68
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
47%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
12,687
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
11.05
Composite VBP score used to determine payment impact.
Payment multiplier
0.9810
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
2.12
Baseline 38.09% · Performance 55.00% · Measure score 2.12 · Achievement 2.12 · Improvement 0
Adjusted total nurse staffing
0.09
Baseline 2.78 hours · Performance 2.96 hours · Measure score 0.09 · Achievement 0 · Improvement 0.09
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.15% |
10.72%
0.6 pts better
|
No Different than the National Rate · Eligible stays 34 · Observed rate 5.88% · Lower 95% interval 6.76% |
| Discharge to community | 51.22% |
50.57%
0.6 pts better
|
No Different than the National Rate · Eligible stays 25 · Observed rate 48% · Lower 95% interval 36.72% |
| Medicare spending per beneficiary | 1.37 |
1.02
0.4 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 39 · Denominator 39 |
| Falls with major injury | 2.56% |
0.77%
1.8 pts worse
|
Numerator 1 · Denominator 39 |
| Discharge self-care score | 29.63% |
53.69%
24.1 pts worse
|
Numerator 8 · Denominator 27 |
| Discharge mobility score | 22.22% |
50.94%
28.7 pts worse
|
Numerator 6 · Denominator 27 |
| Pressure ulcers or injuries, new or worsened | 2.56% |
2.29%
0.3 pts worse
|
Numerator 1 · Denominator 39 · Adjusted rate 2.47% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 24 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 57 |
| Staff flu vaccination coverage | 36.36% |
42%
5.6 pts worse
|
Numerator 48 · Denominator 132 |
| Discharge function score | 29.63% |
56.45%
26.8 pts worse
|
Numerator 8 · Denominator 27 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 12 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 91.1% |
95.4%
4.3 pts worse
|
93.4%
2.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 96.2% · Q2 95.7% · Q3 92.3% · Q4 80.8% · 4Q avg 91.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 87.5% |
96.9%
9.4 pts worse
|
95.5%
8 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 87.5% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 9.9% |
5.1%
4.8 pts worse
|
3.3%
6.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.5% · Q2 13.0% · Q3 11.5% · Q4 3.8% · 4Q avg 9.9% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 61.5% |
4.6%
56.9 pts worse
|
11.4%
50.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 53.8% · Q2 54.5% · Q3 66.7% · Q4 70.8% · 4Q avg 61.5% |
| Percentage of long-stay residents who lose too much weight | 8.8% |
5.5%
3.3 pts worse
|
5.4%
3.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 15.0% · Q3 8.3% · Q4 4.3% · 4Q avg 8.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 11.6% |
17.8%
6.2 pts better
|
19.6%
8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 16.7% · Q2 18.2% · Q3 8.0% · Q4 4.2% · 4Q avg 11.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 26.2% |
25.1%
1.1 pts worse
|
16.7%
9.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.8% · Q3 31.8% · 4Q avg 26.2% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 9.6% |
21.3%
11.7 pts better
|
16.3%
6.7 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 9.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 37.0% |
21.6%
15.4 pts worse
|
14.9%
22.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 41.7% · Q2 31.8% · Q3 47.8% · Q4 26.1% · 4Q avg 37.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.1% |
2.0%
0.1 pts worse
|
1.0%
1.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 5.1% · Q4 3.0% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 4.1% |
3.3%
0.8 pts worse
|
1.7%
2.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 0.0% · Q3 4.0% · Q4 8.0% · 4Q avg 4.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 29.1% |
25.8%
3.3 pts worse
|
19.8%
9.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 39.3% · Q2 32.1% · Q3 7.7% · Q4 37.3% · 4Q avg 29.1% |
| Percentage of long-stay residents with pressure ulcers | 7.8% |
4.6%
3.2 pts worse
|
5.1%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.6% · Q2 13.5% · Q3 2.6% · Q4 7.3% · 4Q avg 7.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 69.7% |
83.2%
13.5 pts worse
|
81.7%
12 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 73.9% · Q2 76.5% · Q3 63.3% · Q4 63.6% · 4Q avg 69.7% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 30.0% |
11.7%
18.3 pts worse
|
12.0%
18 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 30.0% · Observed 30.0% · Expected 11.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.7%
1.7 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 65.7% |
78.2%
12.5 pts worse
|
79.7%
14 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 65.7% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 13.6% |
21.5%
7.9 pts better
|
23.9%
10.3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 13.6% · Observed 10.0% · Expected 17.6% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-09-12 · Fire 2024-09-12
1 health deficiencies
Top issue: Quality of Life and Care (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-06-15 · Fire 2023-06-15
2 health deficiencies
Top issue: Quality of Life and Care (1 deficiency)
7 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Fire safety
Fire-safety citations
C · Minimal harm
2026-01-08
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2026-02-22
B · Minimal harm
2026-01-08
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2026-02-22
B · Minimal harm
2026-01-08
K522 · Services Deficiencies
Fire Safety
Have an externally vented heating system.
Corrected 2026-02-22
B · Minimal harm
2026-01-08
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2026-02-22
F · Potential for more than minimal harm
2023-06-15
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-07-13
F · Potential for more than minimal harm
2023-06-15
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2023-07-05
E · Potential for more than minimal harm
2023-06-15
K226 · Egress Deficiencies
Fire Safety
Have horizontal exits used in accordance with safety requirements.
Corrected 2023-07-17
E · Potential for more than minimal harm
2023-06-15
K271 · Egress Deficiencies
Fire Safety
Have exits that are accessible at all times.
Corrected 2023-07-30
E · Potential for more than minimal harm
2023-06-15
K325 · Smoke Deficiencies
Fire Safety
Have properly installed hallway dispensers for alcohol-based hand rub.
Corrected 2023-07-03
E · Potential for more than minimal harm
2023-06-15
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2023-07-05
D · Potential for more than minimal harm
2023-06-15
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-07-03
Inspection history
Recent health citations
E · Potential for more than minimal harm
2026-01-08
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2026-02-22
E · Potential for more than minimal harm
2026-01-08
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2026-02-22
D · Potential for more than minimal harm
2026-01-08
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2026-02-22
D · Potential for more than minimal harm
2025-07-17
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Not marked corrected
G · Actual harm
2024-09-12
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-10-06
E · Potential for more than minimal harm
2023-06-15
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-07-30
E · Potential for more than minimal harm
2023-06-15
F700 · Quality of Life and Care Deficiencies
Health
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.
Corrected 2023-07-30
Penalties and ownership
What sits behind the stars
$11,057
2024-09-12
Fine
Fine · fine $11,057
Fine
Ownership
Chaim Rajchenbach Descendants Tr Ua 04282008
5% Or Greater Direct Ownership Interest · Organization
Doros Generation Trust U/A/D 1/3/12
5% Or Greater Direct Ownership Interest · Organization
Cibc Bank Usa
5% Or Greater Security Interest · Organization
Legacy Healthcare Financial Services LLC
Operational/Managerial Control · Organization
Rajchenbach, Chaim
Corporate Officer · Individual
Schlomer, Tiffany
W-2 Managing Employee · Individual
Shabat, Menachem
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Jenkin's Living Center
Watertown, SD
1-star overall rating with 1-star inspections with $53,086 in total fines with 9 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Avantara Watertown
Watertown, SD
3-star overall rating with 3-star inspections with $6,368 in total fines with 4 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#3
Sun Dial Manor
Bristol, SD
2-star overall rating with 2-star inspections with $24,528 in total fines with 11 recent health deficiencies
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