Cycle 1
Health 2025-03-13 · Fire 2025-03-13
5 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
4 fire-safety deficiencies
Top issue: Miscellaneous (2 deficiencies)
Milbank, SD
Avantara Milbank
1-star overall rating with 2-star inspections with $55,361 in total fines with 5 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
1103 South Second Street, Milbank, SD
(605) 432-4556
Overall
1 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
55
Certified beds
Average residents
37
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Legacy Healthcare
Operator or chain grouping
Approved since
1967-02-01
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
0.48
Licensed practical nurse staffing · state 0.49 · national 0.87
Aide hours / resident day
1.93
Nurse aide staffing · state 2.61 · national 2.35
Total nurse hours
3.18
All reported nurse hours · state 3.89 · national 3.89
Licensed hours
1.25
RN + LPN hours · state 1.28 · national 1.54
Weekend hours
2.94
Weekend nurse staffing · state 3.32 · national 3.43
Weekend RN hours
0.70
Weekend registered nurse coverage · state 0.51 · national 0.47
Physical therapist
0.06
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.77
CMS adjusted RN staffing hours
Adjusted total hours
3.16
CMS adjusted total nurse staffing hours
Case-mix index
1.38
Higher values indicate more complex resident acuity
RN turnover
77%
Annual RN turnover · state 39% · national 45%
Total nurse turnover
83%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
13,182
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
7.67
Composite VBP score used to determine payment impact.
Payment multiplier
0.9807
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
0
Baseline 44.83% · Performance 70.00% · Measure score 0 · Achievement 0 · Improvement 0
Adjusted total nurse staffing
1.53
Baseline 2.97 hours · Performance 3.51 hours · Measure score 1.53 · Achievement 1.53 · Improvement 1.43
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.28% |
10.72%
1.4 pts better
|
No Different than the National Rate · Eligible stays 40 · Observed rate 0% · Lower 95% interval 6.57% |
| Discharge to community | 35.07% |
50.57%
15.5 pts worse
|
Worse than the National Rate · Eligible stays 38 · Observed rate 26.32% · Lower 95% interval 20.57% |
| Medicare spending per beneficiary | 1.25 |
1.02
0.2 pts worse
|
|
| Drug regimen review with follow-up | 60.87% |
95.27%
34.4 pts worse
|
Numerator 14 · Denominator 23 |
| Falls with major injury | 4.35% |
0.77%
3.6 pts worse
|
Numerator 1 · Denominator 23 |
| Discharge self-care score | 20% |
53.69%
33.7 pts worse
|
Numerator 4 · Denominator 20 |
| Discharge mobility score | 30% |
50.94%
20.9 pts worse
|
Numerator 6 · Denominator 20 |
| Pressure ulcers or injuries, new or worsened | 8.7% |
2.29%
6.4 pts worse
|
Numerator 2 · Denominator 23 · Adjusted rate 7.75% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 18 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 75.47% |
8.2%
67.3 pts better
|
Numerator 40 · Denominator 53 |
| Staff flu vaccination coverage | 40.74% |
42%
1.3 pts worse
|
Numerator 22 · Denominator 54 |
| Discharge function score | 45% |
56.45%
11.5 pts worse
|
Numerator 9 · Denominator 20 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 5 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 10 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.8 |
1.5
0.7 pts better
|
1.9
1.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.8 · Expected 1.9 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.8 |
1.9
0.1 pts better
|
1.8
About the same
|
Long Stay · 20240701-20250630 · Adjusted 1.8 · Observed 1.8 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 74.4% |
95.4%
21 pts worse
|
93.4%
19 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 58.3% · Q2 73.5% · Q3 83.9% · Q4 85.7% · 4Q avg 74.4% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 97.3% |
96.9%
0.4 pts better
|
95.5%
1.8 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 97.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.1% |
5.1%
2 pts better
|
3.3%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 2.9% · Q3 0.0% · Q4 0.0% · 4Q avg 3.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 15.5% |
4.6%
10.9 pts worse
|
11.4%
4.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 6.7% · Q3 25.9% · Q4 29.6% · 4Q avg 15.5% |
| Percentage of long-stay residents who lose too much weight | 2.7% |
5.5%
2.8 pts better
|
5.4%
2.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 3.3% · Q3 4.0% · Q4 0.0% · 4Q avg 2.7% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 23.5% |
17.8%
5.7 pts worse
|
19.6%
3.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 24.2% · Q2 26.7% · Q3 19.2% · Q4 23.1% · 4Q avg 23.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 23.3% |
25.1%
1.8 pts better
|
16.7%
6.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.0% · Q2 27.3% · Q3 22.7% · Q4 23.8% · 4Q avg 23.3% · 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 | 39.6% |
21.3%
18.3 pts worse
|
16.3%
23.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 39.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 29.6% |
21.6%
8 pts worse
|
14.9%
14.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.0% · Q2 33.3% · Q3 36.0% · Q4 24.0% · 4Q avg 29.6% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 5.6% |
2.0%
3.6 pts worse
|
1.0%
4.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 8.3% · Q3 8.8% · Q4 3.1% · 4Q avg 5.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.3% |
3.3%
1 pts better
|
1.7%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.8% · Q2 2.9% · Q3 3.3% · Q4 0.0% · 4Q avg 2.3% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 18.3% |
25.8%
7.5 pts better
|
19.8%
1.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 19.4% · Q2 9.7% · Q3 31.8% · Q4 13.5% · 4Q avg 18.3% |
| Percentage of long-stay residents with pressure ulcers | 10.5% |
4.6%
5.9 pts worse
|
5.1%
5.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 10.7% · Q2 9.9% · Q3 9.6% · Q4 11.9% · 4Q avg 10.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 37.1% |
83.2%
46.1 pts worse
|
81.7%
44.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 25.0% · Q4 60.9% · 4Q avg 37.1% |
| Percentage of short-stay residents who newly received an antipsychotic medication | 6.7% |
1.7%
5 pts worse
|
1.6%
5.1 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 6.7% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-11-08 · Fire 2023-11-08
12 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (3 deficiencies)
3 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Cycle 3
Health 2022-09-01 · Fire 2022-09-01
1 health deficiencies
Top issue: Infection Control (1 deficiency)
4 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Fire safety
Fire-safety citations
E · Potential for more than minimal harm
2025-03-13
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-06-19
D · Potential for more than minimal harm
2025-03-13
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2025-03-18
D · Potential for more than minimal harm
2025-03-13
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2025-04-18
D · Potential for more than minimal harm
2025-03-13
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2025-03-24
F · Potential for more than minimal harm
2023-11-08
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-12-04
D · Potential for more than minimal harm
2023-11-08
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2023-11-24
C · Minimal harm
2023-11-08
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-11-24
E · Potential for more than minimal harm
2022-09-01
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2022-10-21
E · Potential for more than minimal harm
2022-09-01
K223 · Egress Deficiencies
Fire Safety
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2022-10-21
E · Potential for more than minimal harm
2022-09-01
K325 · Smoke Deficiencies
Fire Safety
Have properly installed hallway dispensers for alcohol-based hand rub.
Corrected 2022-10-21
E · Potential for more than minimal harm
2022-09-01
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2022-10-21
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-03-13
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-04-21
E · Potential for more than minimal harm
2025-03-13
F675 · Quality of Life and Care Deficiencies
Health
Honor each resident's preferences, choices, values and beliefs.
Corrected 2025-04-21
E · Potential for more than minimal harm
2025-03-13
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 2025-04-21
D · Potential for more than minimal harm
2025-03-13
F623 · Resident Rights Deficiencies
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2025-04-21
D · Potential for more than minimal harm
2025-03-13
F625 · Resident Rights Deficiencies
Health
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.
Corrected 2025-04-21
G · Actual harm
2024-12-18
F760 · Pharmacy Service Deficiencies
Health
Ensure that residents are free from significant medication errors.
Corrected 2025-01-17
D · Potential for more than minimal harm
2024-12-18
F585 · Resident Rights Deficiencies
Health
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.
Corrected 2025-01-17
D · Potential for more than minimal harm
2024-12-18
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 2025-01-17
G · Actual harm
2024-10-08
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 2024-11-02
G · Actual harm
2024-10-08
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2024-11-02
G · Actual harm
2024-10-08
F692 · Quality of Life and Care Deficiencies
Health
Provide enough food/fluids to maintain a resident's health.
Corrected 2024-11-02
E · Potential for more than minimal harm
2024-08-06
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2024-09-10
G · Actual harm
2023-11-08
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-12-06
G · Actual harm
2023-11-08
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 2023-12-06
E · Potential for more than minimal harm
2023-11-08
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-12-06
D · Potential for more than minimal harm
2023-11-08
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-12-06
D · Potential for more than minimal harm
2023-11-08
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-12-06
E · Potential for more than minimal harm
2022-09-01
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2022-10-21
Penalties and ownership
What sits behind the stars
$28,912
2024-12-18
Fine
Fine · fine $28,912
Fine
$15,041
2024-10-08
Fine
Fine · fine $15,041
Fine
$11,408
2023-11-08
Fine
Fine · fine $11,408
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
Oakway Operations LLC
5% Or Greater Direct Ownership Interest · Organization
Eggers, Austin
Operational/Managerial Control · Individual
Milbank Sd Property Holdings, LLC
5% Or Greater Security Interest · Organization
Pulse, Rebecca
Operational/Managerial Control · Individual
Rajchenbach, Chaim
Operational/Managerial Control · Individual
Shabat, Menachem
Operational/Managerial Control · Individual
Truist Bank
Operational/Managerial Control · Organization
Truist Bank
5% Or Greater Security Interest · Organization
Nearby options
Other facilities in reach
#1
St William's Care Center
Milbank, SD
3-star overall rating with 3-star inspections with $67,379 in total fines with 4 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Fairway View Neighborhoods
Ortonville, MN
1-star overall rating with 2-star inspections with abuse icon flag with 4 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
#3
Wilmot Care Center Inc
Wilmot, SD
2-star overall rating with 1-star inspections with Special Focus status with $28,028 in total fines with 5 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
Jump out