SNF

AVANTARA NORTON

CCN: 435039 · SIOUX FALLS, SD 57105 · Minnehaha County

⚠ Special Focus Facility ⚠ Abuse citation flag

Overview

Address
3600 SOUTH NORTON AVENUE, SIOUX FALLS, SD 57105
Phone
6053389891
Certified beds
110
Avg daily residents
97 (88% of beds filled)
Ownership
For-profit LLC
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1989-04-01
Setting
Urban
—
Rating not available

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
Footnote 18.
— Not Available
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
Footnote 18.
— Not Available
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
Footnote 18.
— Not Available
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
Footnote 18.
— Not Available

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 3.77 4.24 3.43 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.58 0.74 0.53 ≥ 0.55
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 0.73 0.94 0.67 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 2.46 2.56 2.24 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 1.31 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.06 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
3.32
hrs / resident / day
RN (weekend)
0.37
hrs / resident / day
Total nurse (adjusted, weekend)
3.02
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
57.7%
annual
RN turnover
58.8%
annual
Administrators departed
0
last 12 months

Resident acuity

Nursing Case-Mix Index
1.50
higher acuity than avg
Case-Mix Index Ratio
1.09
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-03-05 19 9 11 160 1 160
Cycle 2/3 (prior) 2023-11-09 41 19 25 583 1 583
Total weighted health score
265.8
lower is better

Deficiencies (77)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

59 D/E/F Actual harm — potential for minor
16 G/H/I Actual harm
2 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. D 2025-12-30 —
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. D 2025-12-30 —
0880 Provide and implement an infection prevention and control program. E 2025-11-14 2025-12-12
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. D 2025-07-10 2025-05-28
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2025-07-10 2025-08-04
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. G 2025-07-10 2025-05-01
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. D 2025-07-10 2025-06-07
0602 Protect each resident from the wrongful use of the resident's belongings or money. D 2025-04-10 2025-04-09
0624 Prepare residents for a safe transfer or discharge from the nursing home. D 2025-04-10 —
0658 Ensure services provided by the nursing facility meet professional standards of quality. E 2025-04-10 —
0582 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. E 2025-03-05 2025-04-04
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-03-05 2025-04-04
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2025-03-05 2025-04-04
0695 Provide safe and appropriate respiratory care for a resident when needed. E 2025-03-05 2025-04-04
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. E 2025-03-05 2025-04-04
0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. E 2025-03-05 2025-04-04
0837 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. E 2025-03-05 2025-04-04
0880 Provide and implement an infection prevention and control program. E 2025-03-05 2025-04-04
0675 Honor each resident's preferences, choices, values and beliefs. H 2025-03-05 2025-04-04
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. D 2024-12-27 2025-02-10
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. D 2024-11-14 2024-12-11
0657 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. D 2024-10-29 2024-11-27
0726 Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. G 2024-10-29 2024-11-27
0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted D 2024-09-26 2024-11-10
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. G 2024-08-21 2024-09-20
0760 Ensure that residents are free from significant medication errors. E 2024-08-21 2024-09-20
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. E 2024-08-21 2024-09-20
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F 2024-07-17 2024-08-26
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. G 2024-06-20 2024-05-30
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2024-06-20 2024-05-30
0726 Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. D 2024-04-16 2024-04-14
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2024-03-13 2024-04-08
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. G 2024-03-13 2024-04-08
0697 Provide safe, appropriate pain management for a resident who requires such services. G 2024-03-13 2024-04-08
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. D 2023-12-14 2024-01-11
0585 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. D 2023-12-14 2024-01-11
0561 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. E 2023-11-09 2023-12-14
0565 Honor the resident's right to organize and participate in resident/family groups in the facility. E 2023-11-09 2023-12-14
0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. E 2023-11-09 2023-12-14
0625 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. E 2023-11-09 2023-12-14
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2023-11-09 2023-12-14
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2023-11-09 2023-12-14
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. H 2023-11-09 2023-12-14
0692 Provide enough food/fluids to maintain a resident's health. E 2023-11-09 2023-12-14
0725 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. H 2023-11-09 2023-12-07
0756 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. E 2023-11-09 2023-12-14
0758 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. E 2023-11-09 2023-12-14
0802 Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. E 2023-11-09 2023-12-14
0809 Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. E 2023-11-09 2023-12-14
0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. F 2023-11-09 2023-12-14

Showing 50 most recent of 77. See the All Data CSV for the full list.

Penalties (7)

Fines issued
7
last 3 years
Total fines
$191,055
Date Type Fine amount
2024-09-26 Fine $12,035
2024-07-17 Fine $12,035
2024-06-20 Fine $12,035
2023-10-04 Fine $28,600
2023-03-23 Fine $37,417
2024-03-13 Fine $37,557
2025-03-05 Fine $51,376

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 12.8% Medicaid 66.0% Other 21.3%

Operating performance

Operating Margin
-5.8%
Total Margin
-5.7%
Occupancy Rate
91.5%
Cost per Resident Day
$37

Revenue & costs

Net Patient Revenue
$10.3M
Total Costs
$1.2M
Net Income
-$588K

Balance sheet

Total Assets
$2.4M
Total Liabilities
$3.9M
Fund Balance
-$1.5M
Current Ratio
0.41

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: LEGACY HEALTHCARE

Chain ID
306
Facilities in chain
90
Legal business name
NORTON SD SKILLED NURSING FACILITY LLC
Chain-average star ratings (for peer context)
Overall
3.0
Health
3.0
Staffing
2.6
QM
3.2

Owner / manager organizations (7)

Organization Role Association
CHAIM RAJCHENBACH DESCENDANTS TR UA 04282008 5% OR GREATER DIRECT OWNERSHIP INTEREST since 10/02/2019
DOROS GENERATION TRUST U/A/D 1/3/12 5% OR GREATER DIRECT OWNERSHIP INTEREST since 10/02/2019
OAKWAY OPERATIONS LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 10/02/2019
BOKF,NA OPERATIONAL/MANAGERIAL CONTROL since 03/04/2024
LEGACY HEALTHCARE FINANCIAL SERVICES LLC OPERATIONAL/MANAGERIAL CONTROL since 10/02/2019
BOKF,NA 5% OR GREATER SECURITY INTEREST since 03/04/2024
NORTON SD PROPERTY HOLDINGS, LLC 5% OR GREATER SECURITY INTEREST since 10/02/2019

Owner / manager individuals (3)

Name Role Association
NICKEL, ASHLEY OPERATIONAL/MANAGERIAL CONTROL since 08/28/2022
REES, JOSEPH OPERATIONAL/MANAGERIAL CONTROL since 10/02/2019
SHABAT, MENACHEM OPERATIONAL/MANAGERIAL CONTROL since 10/02/2019

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Special focus status
SFF
Abuse citation flag
Yes — last 2 cycles
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 113 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $37 metrics.cost_per_resident_day
Cost Report Current Ratio 0.41 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 66.0% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 12.8% metrics.medicare_day_share
Cost Report Net Income ($) $-588,220 metrics.net_income
Cost Report Net Patient Revenue ($) $10,349,099 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 91.5% metrics.occupancy_rate
Cost Report Operating Margin (%) -5.8% metrics.operating_margin
Cost Report Total Assets ($) $2,410,818 metrics.total_assets
Cost Report Total Costs ($) $1,235,347 metrics.total_costs
Cost Report Total Fund Balances ($) $-1,485,905 metrics.fund_balance
Cost Report Total Liabilities ($) $3,896,723 metrics.total_liabilities
Cost Report Total Margin (%) -5.7% metrics.total_margin
Provider Information Abuse Icon Y Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.66509 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 2.24124 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.52804 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.43437 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 3.02158 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 96.6 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.94019 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.55523 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.74108 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 4.23649 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.73402 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 3.0 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 3.0 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 3.2 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 2.6 Chain Average Staffing Rating
Provider Information Chain ID 306 Chain ID
Provider Information Chain Name LEGACY HEALTHCARE Chain Name
Provider Information City/Town SIOUX FALLS City/Town
Provider Information CMS Certification Number (CCN) 435039 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Minnehaha County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1989-04-01 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating — Health Inspection Rating
Provider Information Health Inspection Rating Footnote 18 Health Inspection Rating Footnote
Provider Information Latitude 43.5126 Latitude
Provider Information Legal Business Name NORTON SD SKILLED NURSING FACILITY LLC Legal Business Name
Provider Information Location 3600 SOUTH NORTON AVENUE,SIOUX FALLS,SD,57105 Location
Provider Information Long-Stay QM Rating — Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote 18 Long-Stay QM Rating Footnote
Provider Information Longitude -96.735 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 0 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 110 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections — Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 90 Number of Facilities in Chain
Provider Information Number of Fines 7 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.50080 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 1.08939 Nursing Case-Mix Index Ratio
Provider Information Overall Rating — Overall Rating
Provider Information Overall Rating Footnote 18 Overall Rating Footnote
Provider Information Ownership Type For profit - Limited Liability company Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 3600 SOUTH NORTON AVENUE Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name AVANTARA NORTON Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 490 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating — QM Rating
Provider Information QM Rating Footnote 18 QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 160 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 11 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 9 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-03-05 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 160 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 19 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 19 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2023-11-09 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 583 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 25 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 583 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 41 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.37079 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 58.8 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 1.30919 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 0.72979 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.45925 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.05644 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.57940 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 3.76844 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating — Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote 18 Short-Stay QM Rating Footnote
Provider Information Special Focus Status SFF Special Focus Status
Provider Information Staffing Rating — Staffing Rating
Provider Information Staffing Rating Footnote 18 Staffing Rating Footnote
Provider Information State SD State
Provider Information Telephone Number 6053389891 Telephone Number
Provider Information Total Amount of Fines in Dollars 191055.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 3.31550 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 7 Total Number of Penalties
Provider Information Total nursing staff turnover 57.7 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 265.750 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 57105 ZIP Code