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Nursing homeFAID #11680

Avantara Watertown

415 FOURTH AVE NE, WATERTOWN, SD, 57201
(605) 886-8431
51 licensed beds
★★★★★1/5CMS Five-Star overall1/5 health inspections3/5 staffing2/5 quality measuresSource: CMS Care Compare

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Public record summary

What we can show you for free.
Bed capacity
51
CMS facility ID
435068
Care type
Nursing home
County
Codington
Facility name
Avantara Watertown
Street address
415 FOURTH AVE NE
City / state / ZIP
Watertown, SD 57201
Phone
(605) 886-8431

About this facility — Avantara Watertown

Avantara Watertown is a Medicare/Medicaid-certified skilled nursing facility in Watertown, South Dakota. It is licensed for 51 beds — close to the median for skilled nursing facilities in South Dakota (52 beds).

It is one of 10 senior care facilities in Watertown and 96 skilled nursing facilities across South Dakota. Families comparing options should weigh inspection history, ownership record, and litigation — not just the tour — before deciding.

Federal inspectors have cited Avantara Watertown 40 times across 11 inspections in the last three years, including 1 food-safety citation, and CMS has imposed $6,368 in fines. Every citation is listed, dated, and graded in the inspection record below.

This listing draws on federal CMS Nursing Home Compare records, and was last updated on August 31, 2026. Background reports are compiled from primary sources — state inspection files, federal CMS data, corporate registrations, and court records — at the time of order.

Facility background

What the public record shows.

Ownership & operator

Parent company
Legacy Healthcare
Ownership type
For profit - Limited Liability company

Registered owners & officers

Doros Generation Trust U/a/d 1/3/12
Direct owner · Additional disclosable party — 43% stake — since 2019
Gpn Family Trust U/a/d 4/28/08
Direct owner · Additional disclosable party — 43% stake — since 2019
Oakway Operations Llc
Direct owner — 15% stake — since 2019
Legacy Healthcare Financial Services Llc
Additional disclosable party — since 2019
Rajchenbach, Chaim
Governing body · Operational control · Additional disclosable party — since 2019
Rsm Us Llp
Additional disclosable party — since 2024
Shabat, Menachem
Governing body · Operational control · Additional disclosable party — since 2019
Shives, Aaron
Operational control · Additional disclosable party — since 2019
Speier, Lynna
Operational control · Additional disclosable party — since 2025
Truist Bank
Security-interest holder · Operational control — since 2022
Watertown Sd Property Holdings, Llc
Security-interest holder · Additional disclosable party — since 2019

Regulatory standing

Federal court records
20 naming its parent company — view the cases (a listed case is not a finding of wrongdoing)
Licensed / certified since
1993-03-01
CMS overall rating
1 of 5 stars
Health deficiencies
26 at the last standard inspection
Federal fines
$6,368 total
Last standard inspection
2026-04-29
Nurse staffing
3.6 hours per resident per day

Cost & payer profile (FY2023 cost report)

Average billed charges
$471 per day (≈ $14,320/month). Private-pay prices typically track billed charges; Medicare and Medicaid pay set rates.
Payer mix (resident days)
54% Medicaid · 13% Medicare · 32% private/other
Occupancy
90% (fiscal year 2023)
Vs. state median
14% above the SD median of $412/day — full state cost breakdown

Services & coverage

Licensed beds
51
Medicare
Accepted
Medicaid
Accepted
Compiled from CMS Nursing Home Compare; owners/officers from the CMS Ownership dataset; cost & occupancy from the facility's own CMS cost report · last verified 2026-08-31. Facilities can submit a correction.

Inspection record

Every citation, dated and graded.

Kitchen & food safety

Federal surveyors inspect the kitchen at every standard visit. This facility has 1 food-safety citation on its three-year record — flagged below among the inspections.
2026-06-17Health inspectionComplaint-triggered1 citation
F-0684
E · No harm foundFrom a complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2026-08-01
2026-04-29Health inspectionComplaint-triggered25 citations
F-0550
E · No harm foundFrom a complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2026-06-02
F-0552
D · No harm found
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2026-06-02
F-0554
D · No harm found
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2026-06-02
F-0583
F · No harm found
Keep residents' personal and medical records private and confidential.
Corrected 2026-06-02
F-0585
E · No harm found
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 2026-06-02
F-0600
J · Immediate jeopardy
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2026-06-02
F-0605
D · No harm found
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected 2026-06-02
F-0609
E · No harm foundFrom a complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2026-06-02
F-0628
D · No harm found
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2026-06-02
F-0641
D · No harm found
Ensure each resident receives an accurate assessment.
Corrected 2026-06-02
F-0644
D · No harm found
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2026-06-02
F-0655
E · No harm foundFrom a complaint
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2026-06-02
F-0657
E · No harm foundFrom a complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2026-06-02
F-0658
D · No harm found
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2026-06-02
F-0689
K · Immediate jeopardyFrom a complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2026-06-02
F-0695
E · No harm found
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2026-06-02
F-0700
E · No harm found
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 2026-06-02
F-0755
D · No harm foundFrom a complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2026-06-02
F-0759
D · No harm found
Ensure medication error rates are not 5 percent or greater.
Corrected 2026-06-02
F-0760
G · Actual harm
Ensure that residents are free from significant medication errors.
Corrected 2026-06-02
F-0761
D · No harm found
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.
Corrected 2026-06-02
F-0806
D · No harm foundFood safety
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected 2026-06-02
F-0835
F · No harm foundFrom a complaint
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected 2026-06-02
F-0837
F · No harm found
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.
Corrected 2026-06-02
F-0865
F · No harm found
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected 2026-06-02
7 earlier / fire-safety inspections (14 citations)
2025-03-06Health inspectionComplaint-triggered1 citation
F-0760
G · Actual harmFrom a complaint
Ensure that residents are free from significant medication errors.
Corrected 2025-02-28
2024-12-05Health inspectionComplaint-triggered3 citations
F-0550
E · No harm found
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2025-01-06
F-0755
E · No harm foundFrom a complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-01-06
F-0761
E · No harm found
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.
Corrected 2025-01-06
2024-03-19Health inspectionComplaint-triggered1 citation
F-0677
E · No harm foundFrom a complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2024-04-24
2023-09-28Health inspection1 citation
F-0761
E · No harm found
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.
Corrected 2023-11-06
2026-04-29Fire-safety inspection4 citations
K-0222
D · No harm found
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2026-05-05
K-0223
C · No harm found
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2026-05-05
K-0291
D · No harm found
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2026-05-11
K-0321
D · No harm found
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2026-05-05
2024-12-05Fire-safety inspection2 citations
K-0211
F · No harm found
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-01-06
K-0754
E · No harm found
Provide properly sized and located linen or trash receptacles.
Corrected 2025-01-06
2023-09-28Fire-safety inspection2 citations
K-0131
D · No harm found
Meet requirements for sections of health care facilities separated by fire resistive construction.
Corrected 2023-10-25
K-0712
D · No harm found
Have simulated fire drills held at unexpected times.
Corrected 2023-10-17

Federal penalties

2025-03-06Fine$6,368
Citations and penalties from the CMS Provider Data Catalog (three-year survey window, refreshed monthly). Severity codes follow the federal scope/severity grid; “Immediate jeopardy” is the most serious grade CMS issues. CCN 435068.

Inside your report

What unlocks when you order.

Ownership & corporate history

Primary tier
Prior operators & transfers
Corporate network & affiliates
,
Owners' other facilities
· · 2 more

Inspection citations — last 5 years

Locked
The 40 citations above are shown free. The report takes each one and explains it in plain English — what the tag requires, how serious the scope/severity grade really is, whether it recurred across surveys — plus the five-year pattern a single inspection can't show.

Civil & criminal lawsuits

Advanced tier only
Active civil suits
#
Federal dockets
CDC infection data
Unlock the full file
Citations, owner history, lawsuits — decoded into one PDF.
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Original records

Sources we pull for this facility.
Source
CMS Nursing Home Compare
data.cms.gov Provider Data Catalog
Last verified 2026-08-31
Source
Secretary of State filings
Entity & officer search
Pulled when a report is ordered
Source
PACER federal dockets
pacer.uscourts.gov
Pulled when a report is ordered