AVANTARA WATERTOWN

415 FOURTH AVE NE, WATERTOWN, SD 57201

Operator

DOROS GENERATION TRUST UAD 1312 · 73 facilities

Provider number (CCN): 435068
Certification: Medicare and Medicaid
Ownership: For profit - Limited Liability company
Certified beds: 51
Phone: (605) 886-8431
CMS data as of: August 1, 2026

●

stable

Staffing 0% · Deficiencies +4% over tracking period

What the records show

CMS rates AVANTARA WATERTOWN 1 out of 5 stars overall, with 1 of 5 for health inspections, 3 of 5 for staffing, 2 of 5 for quality measures. Federal inspectors cited 32 health deficiencies across the last three survey cycles, most recently surveyed in 2026, 4 at actual-harm level or higher, 1 still recorded as uncorrected. CMS enforcement records list 1 fine totalling $6,368.

Facility Assessment 1 federal violation at this facility remains unresolved. Inspectors recorded 4 citations at the actual-harm level or worse in the last three survey cycles.

Reviews, Ratings and Official Records

This page reviews AVANTARA WATERTOWN using federal government records — CMS star ratings, health-inspection findings, staffing data and enforcement actions. NursingHomeGrade does not collect, host or publish resident or family testimonials, and no star rating below is a consumer review score.

At or above the 2024 benchmark — review the inspection and enforcement records below for the safety history behind the grade.

Ratings and Grade Breakdown

RN Staffing Registered nurse time each resident receives daily. 2024 federal benchmark: 0.55 hrs. Repealed February 2026.	1.06 — At or above the repealed 0.55 hr benchmark
The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced. We still grade against it. Why
Health Deficiencies (last 3 survey cycles) Violations found during federal inspections, with how many remain open and how many involved actual harm.	Total 32 Outstanding 1 Actual harm or worse (G–L) 4
CMS Ratings Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.	Overall: ★☆☆☆☆ (1/5) Health inspection: ★☆☆☆☆ (1/5) Quality: ★★☆☆☆ (2/5) Staffing: ★★★☆☆ (3/5)
NursingHomeGrade Score	23/100

Loaded into NursingHomeGrade on September 5, 2026. This is the load date, not the date CMS published the underlying survey data — see release dates.

CMS scores each facility from one to five stars — one is in the bottom fifth of facilities in its state on health inspections, five is in the top tenth. Our own A–F grade is a separate 0–100 score built from staffing hours, inspection citations, and the severity and correction status of those citations, weighted as described in our grading methodology.

Staffing Compared With State and National Levels

Registered nurse hours per resident per day compared with state and national levels
This facility	1.06 hrs
SD median	0.76 hrs
National average	0.69 hrs

Registered nurse turnover: 27.3% · Total nursing staff turnover: 44.2%

Staffing figures are the values CMS published in its file processed August 1, 2026, drawn from payroll-based journal reporting.

Inspection Records Covered

Most recent standard health survey: April 29, 2026.
Citations shown below span 3 recorded inspection cycles.
Survey dates on file range from September 28, 2023 to June 17, 2026.

Source records: CMS Care Compare profile for provider 435068 ↗ · the federal files we load and when.

Inspection Deficiencies

Health inspections identify violations of federal standards. Severity ranges from no actual harm (A–F) to immediate jeopardy (J–L).

2 immediate jeopardy, 2 actual harm issues found among 32 total deficiencies. 31 corrected. — 1 still outstanding

Most recent inspection (April 29, 2026)

E Potential harm — pattern F0684 Status: Outstanding — Plan Filed

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies — Deficient, Provider has plan of correction, corrected August 1, 2026

F Potential harm — widespread F0835 Status: Corrected

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

Administration Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

F Potential harm — widespread F0837 Status: Corrected

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.

Administration Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

F Potential harm — widespread F0865 Status: Corrected

Have a plan that describes the process for conducting QAPI and QAA activities.

Administration Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

J Immediate jeopardy — isolated F0600 Status: Corrected

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

E Potential harm — pattern F0609 Status: Corrected

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0605 Status: Corrected

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0806 Status: Corrected

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

G Actual harm — isolated F0760 Status: Corrected

Ensure that residents are free from significant medication errors.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0755 Status: Corrected

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0759 Status: Corrected

Ensure medication error rates are not 5 percent or greater.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0761 Status: Corrected

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.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

K Immediate jeopardy — pattern F0689 Status: Corrected

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

E Potential harm — pattern F0695 Status: Corrected

Provide safe and appropriate respiratory care for a resident when needed.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

E Potential harm — pattern F0700 Status: Corrected

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.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

E Potential harm — pattern F0655 Status: Corrected

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

E Potential harm — pattern F0657 Status: Corrected

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0641 Status: Corrected

Ensure each resident receives an accurate assessment.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0644 Status: Corrected

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

D Potential harm — isolated F0658 Status: Corrected

Ensure services provided by the nursing facility meet professional standards of quality.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 2, 2026

F Potential harm — widespread F0583 Status: Corrected

Keep residents' personal and medical records private and confidential.