Map showing the location of AVANTARA HURON in HURON, South Dakota
1345 MICHIGAN AVENUE SW, HURON, SD, 57350

Overall Score

CMS Five-Star Quality Rating
3/5AverageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • South DakotaAbove only 49% of peers95 rated homes · average 2.9★
  • United StatesAbove only 41% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point3★+0.2 vs SD avg
  • StaffingCan add or remove a star3★−0.5 vs SD avg
  • Quality measuresCan add or remove a star3★+0.1 vs SD avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles3★Above only 47% of peersSD avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover3★Above only 16% of peersSD avg3.5★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments3★Above only 44% of peersSD avg2.9★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.61hrsAbove only 43% of peersSD avg3.89Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.59hrsAbove only 23% of peersSD avg0.80Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better57%Above only 28% of peersSD avg50%RN turnover25%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$8,338Above 61% of peersSD avg$25,187Fines · denials1 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
11citations
4inspection dates
2actual harm (G–I)
0immediate jeopardy (J–L)
Nov 14, 2024most recent

Citations by monthAug 2022 – Nov 2024

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Nov 14, 20248 citationsCycle 1worst G · actual harm$8,338
  1. 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.Resident RightsD · isolatedCorrected Dec 12, 2024
  2. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Dec 12, 2024
  3. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningE · patternCorrected Dec 12, 2024
  4. F657Develop 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 PlanningD · isolatedCorrected Dec 12, 2024
  5. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Dec 12, 2024
  6. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Dec 12, 2024
  7. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Dec 12, 2024
  8. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Oct 26, 2024
Jun 19, 20241 citationCycle 2worst D · no actual harm
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryD · isolatedCorrected Aug 3, 2024
Feb 20, 20231 citationCycle 3worst D · no actual harm
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Mar 17, 2023
Aug 4, 20221 citationCycle 3worst G · actual harm
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Aug 31, 2022

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.61hrsAbove only 43% of peers−0.28 vs SD avg
  • Registered nursesRN hours only0.59hrsAbove only 23% of peers−0.21 vs SD avg
  • Licensed practical nursesLPN hours0.58hrs
  • Nurse aidesCNA hours2.45hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.05hrs
  • South Dakota average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better57%Above only 28% of peersSD avg 50%
  • RN turnoverRegistered nurses only25%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy119 certified beds · ~66 residents a day55%Above only 3% of peersSD avg 84%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $8,338In fines
  • 1Fine
  • 0Payment denials
  • $25,187SD avg in fines
Above 61% of peersFewer fines than 61% of rated homes in South Dakota

Actions on record

  1. Nov 14, 2024Civil money penalty$8,338

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Legacy Healthcare90 facilities in the chain3.0★ chain average
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Doros Generation Trust U/A/D 1/3/12
  • Gpn Fam Tr Ua 04282008
Operational or managerial control
  • Legacy Healthcare Financial Services LLC
Corporate officers
  • Menachem Shabat
Managing employees
  • Laurie Solem

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 435020 · 1345 MICHIGAN AVENUE SW, HURON, SD, 57350.
  • Percentiles compare this facility with every rated nursing home in South Dakota and Beadle County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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