Federal inspection record · CMS data as of October 1, 2026
Avantara Lake Norden
803 Park Street, Lake Norden, SD · (605) 785-3654
- Certified beds
- 50
- Residents per day
- 45
- Ownership
- For-Profit
- Chain
- Legacy Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- May 1, 1991
1
How this home got 5 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in South Dakota.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among South Dakota homes
Avantara Lake Norden carries 27 inspection points. That is fewer than 71% of South Dakota's 94 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in South Dakota: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–14 pts
- 4★ 14–31.5 pts
- 3★ 31.5–55 pts
- 2★ 55–95.25 pts
- 1★ over 95.25 pts
Bars show every rated home in South Dakota by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
7 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
J
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Everything else, by area of care
Infection Control2E
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning2D
- B
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care1D
- D
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Pharmacy Service1E
- E
Ensure that residents are free from significant medication errors.
Inspection history
2026-07-09
4 health deficiencies · 2 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
2025-03-20
1 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (1 deficiency)
2023-11-16
2 health deficiencies · 1 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h 21 min of nursing staff time a day, 43 min of it from a registered nurse.
This home
3 h 21 min
South Dakota average
3 h 51 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 39% of nursing staff and 14% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$14,901 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-02-19 | Fine | $14,901 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.6 pts better | 0.9 | 1.5 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1 pts better | 0.7 | 1.7 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine5.1 pts better | 100.0% | 94.9% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.8 pts better | 100.0% | 97.2% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.2 pts better | 2.3% | 5.5% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms11.3 pts worse | 17.2% | 5.9% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.2 pts worse | 5.9% | 5.7% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication9.6 pts worse | 27.3% | 17.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.2 pts better | 19.6% | 24.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8.8 pts better | 9.5% | 18.3% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased11.8 pts worse | 33.3% | 21.5% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1.9 pts better | 0.0% | 1.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2.3 pts better | 0.6% | 2.9% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence2.7 pts worse | 27.2% | 24.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.3 pts better | 2.2% | 4.5% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine16.1 pts better | 100.0% | 83.9% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.2 pts better | 0.0% | 2.2% | 1.5% |
·
Who owns and runs it
21 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Doros Generation Trust U/A/D 1/3/12 | 5% Or Greater Direct Ownership Interest · Organization | 43% | 76 facilities |
| Gpn Family Trust U/A/D 4/28/08 | 5% Or Greater Direct Ownership Interest · Organization | 43% | 80 facilities |
| Oakway Operations LLC | 5% Or Greater Direct Ownership Interest · Organization | 15% | 46 facilities |
| Devine, William | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Devine, William | Adp Of The SNF · Individual | 0% | 1 facilities |
| Doros Generation Trust U/A/D 1/3/12 | Adp Of The SNF · Organization | 0% | 76 facilities |
| Gpn Family Trust U/A/D 4/28/08 | Adp Of The SNF · Organization | 0% | 80 facilities |
| Grimm, Margaret | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Grimm, Margaret | Adp Of The SNF · Individual | 0% | 1 facilities |
| Lake Norden Sd Property Holdings, LLC | 5% Or Greater Security Interest · Organization | 0% | 1 facilities |
| Lake Norden Sd Property Holdings, LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Legacy Healthcare Financial Services LLC | Adp Of The SNF · Organization | 0% | 78 facilities |
| Rajchenbach, Chaim | Managing Control - Governing Body · Individual | 0% | 55 facilities |
| Rajchenbach, Chaim | Operational/Managerial Control · Individual | 0% | 55 facilities |
| Rajchenbach, Chaim | Adp Of The SNF · Individual | 0% | 55 facilities |
| Rsm Us Llp | Adp Of The SNF · Organization | 0% | 18 facilities |
| Shabat, Menachem | Managing Control - Governing Body · Individual | 0% | 86 facilities |
| Shabat, Menachem | Operational/Managerial Control · Individual | 0% | 86 facilities |
| Shabat, Menachem | Adp Of The SNF · Individual | 0% | 86 facilities |
| Truist Bank | 5% Or Greater Security Interest · Organization | 0% | 77 facilities |
| Truist Bank | Operational/Managerial Control · Organization | 0% | 77 facilities |
·
Fire safety
5 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke2D
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install corridor and hallway doors that block smoke.
Egress1D
- D
Have properly located and lighted "Exit" signs.
Miscellaneous1D
- D
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems1C
- C
Have a battery powered remote alarm panel in a location accessible by operating personnel.
·
Other homes nearby
-
Estelline Nursing and Care Center
Estelline, SD
★★★★★- Worst citation, 3 yrs
- L
- Nursing / resident / day
- 3 h 14 min
- Fines
- $16,826
-
Good Samaritan Society De Smet
De Smet, SD · Good Samaritan Society
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 55 min
- Fines
- $27,989
-
Jenkin's Living Center
Watertown, SD
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 28 min
- Fines
- $43,771