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Nursing homesSouth Dakota › Avantara Watertown

Avantara Watertown

415 Fourth Ave Ne, Watertown, SD 57201 · 6058868431 · 51 certified beds

Overall★☆☆☆☆ 1/5
Health inspections★☆☆☆☆ 1/5
Staffing★★★☆☆ 3/5
Quality measures★★☆☆☆ 2/5
Special Focus: CMS lists this facility as SFF Candidate — among the facilities with the most serious ongoing compliance problems in the country.
Abuse icon: CMS flags this facility for an abuse citation in recent inspections.

Ownership group

Per CMS filings, this facility is affiliated with Legacy Healthcare, a group operating 89 facilities in 3 states. Group record: average rating 3.0/5, 7 abuse citation icons, 4 facilities on the Special Focus list, $3,703,514 in federal fines. This facility rates below its group average (3.0/5).

See all 89 facilities in this group →

Staffing (hours per resident per day)

Total nurse staffing: 3.57 (South Dakota median: 3.63). RN hours: 1.06. Weekend total: 2.87. Nursing staff turnover: 44%.

Inspection deficiencies

All-time on record: 31 deficiency citations, including 2 at immediate-jeopardy level. Below: citations from 2023 onward (severity letters explained in methodology).

Survey dateDeficiencySev.TypeStatus
2026-04-29Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Kcomplaintcorrected 2026-06-02
2026-04-29Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. JHealthcorrected 2026-06-02
2026-04-29Ensure that residents are free from significant medication errors. GHealthcorrected 2026-06-02
2026-04-29Keep residents' personal and medical records private and confidential. FHealthcorrected 2026-06-02
2026-04-29Administer the facility in a manner that enables it to use its resources effectively and efficiently. Fcomplaintcorrected 2026-06-02
2026-04-29Establish 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. FHealthcorrected 2026-06-02
2026-04-29Have a plan that describes the process for conducting QAPI and QAA activities. FHealthcorrected 2026-06-02
2026-04-29Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Ecomplaintcorrected 2026-06-02
2026-04-29Honor 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. EHealthcorrected 2026-06-02
2026-04-29Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Ecomplaintcorrected 2026-06-02
2026-04-29Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Ecomplaintcorrected 2026-06-02
2026-04-29Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Ecomplaintcorrected 2026-06-02
2026-04-29Provide safe and appropriate respiratory care for a resident when needed. EHealthcorrected 2026-06-02
2026-04-29Try 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. EHealthcorrected 2026-06-02
2026-04-29Ensure that residents are fully informed and understand their health status, care and treatments. DHealthcorrected 2026-06-02
2026-04-29Allow residents to self-administer drugs if determined clinically appropriate. DHealthcorrected 2026-06-02
2026-04-29Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. DHealthcorrected 2026-06-02
2026-04-29Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. DHealthcorrected 2026-06-02
2026-04-29Ensure each resident receives an accurate assessment. DHealthcorrected 2026-06-02
2026-04-29Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. DHealthcorrected 2026-06-02
2026-04-29Ensure services provided by the nursing facility meet professional standards of quality. DHealthcorrected 2026-06-02
2026-04-29Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Dcomplaintcorrected 2026-06-02
2026-04-29Ensure medication error rates are not 5 percent or greater. DHealthcorrected 2026-06-02
2026-04-29Ensure 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. DHealthcorrected 2026-06-02
2026-04-29Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. DHealthcorrected 2026-06-02
2025-03-06Ensure that residents are free from significant medication errors. Gcomplaintcorrected 2025-02-28
2024-12-05Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. EHealthcorrected 2025-01-06
2024-12-05Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Ecomplaintcorrected 2025-01-06
2024-12-05Ensure 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. EHealthcorrected 2025-01-06
2024-03-19Provide care and assistance to perform activities of daily living for any resident who is unable. Ecomplaintcorrected 2024-04-24
2023-09-28Ensure 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. EHealthcorrected 2023-11-06

Federal penalties

DateTypeAmount
2025-03-06Fine$6,368

Ownership & control records (CMS filings)

NameRoleType%Since
DOROS GENERATION TRUST U/A/D 1/3/125% Or Greater Direct Ownership InterestOrganization43%since 07/01/2019
GPN FAMILY TRUST U/A/D 4/28/085% Or Greater Direct Ownership InterestOrganization43%since 07/01/2019
OAKWAY OPERATIONS LLC5% Or Greater Direct Ownership InterestOrganization15%since 07/01/2019
RAJCHENBACH, CHAIMManaging Control - Governing BodyIndividualNOT APPLICABLEsince 07/01/2019
SHABAT, MENACHEMManaging Control - Governing BodyIndividualNOT APPLICABLEsince 07/01/2019
TRUIST BANKOperational/Managerial ControlOrganizationNOT APPLICABLEsince 04/01/2022
RAJCHENBACH, CHAIMOperational/Managerial ControlIndividualNOT APPLICABLEsince 07/01/2019
SHABAT, MENACHEMOperational/Managerial ControlIndividualNOT APPLICABLEsince 07/01/2019
SHIVES, AARONOperational/Managerial ControlIndividualNOT APPLICABLEsince 07/01/2019
SPEIER, LYNNAOperational/Managerial ControlIndividualNOT APPLICABLEsince 10/01/2025

Compare nearby (Codington County)

Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 435068. Corrections: data@carerecords.org.