South Dakota › Pennington County › Rapid City
Avantara Arrowhead
2500 Arrowhead Dr, Rapid City, SD 57702
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Avantara Arrowhead, in Rapid City, South Dakota, is certified for 68 beds under for-profit, limited liability company ownership and belongs to the Legacy Healthcare chain.
CMS gives it 1 of 5 stars overall, below the South Dakota median of 3; the health inspection rating is 1, staffing 2 and quality measures 2.
Inspectors recorded 45 health deficiencies across the three most recent survey cycles (13, 25, 7 by cycle, most recent first), 10 of them at the actual-harm or immediate-jeopardy level. That is 66.2 per 100 beds, more than the state median of 23.9.
CMS lists 6 penalties in the period covered: fines totalling $154K.
Reported nurse staffing is 3.5 hours per resident per day (1.0 RN), close to the South Dakota median of 3.6; nursing staff turnover is 76.1%.
CMS flags that the facility carries the CMS abuse icon.
Compared with county, state and nation
| Measure | This facility | Pennington Co. median | South Dakota median | US average |
|---|---|---|---|---|
| Overall star rating | 1 | 2 | 3 | 3.0 |
| Health citations, 3 cycles | 45 | 18 | 16 | 28.7 |
| Citations per 100 beds | 66.2 | 25.0 | 23.9 | 26.8 |
| Total nurse hours per resident day | 3.5 | 3.6 | 3.6 | 3.9 |
| RN hours per resident day | 1.0 | 1.0 | 0.8 | 0.7 |
| Nursing staff turnover | 76.1% | 53.7% | 46.6% | 45.8% |
| Fines listed | $153,583 | $22,526 | $20,183 | — |
County and state figures are medians across facilities (9 in the county, 96 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: South Dakota average per facility for the same cycle, as published by CMS. Standard health survey dates: 22 Jun 2026, 11 Sep 2025.
Severity mix: G ×10 D ×24 E ×10 F ×1
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 22 Jun 2026 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | Complaint investigation | 27 Mar 2026 |
| 22 Jun 2026 | F0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | Complaint investigation | 4 Aug 2026 |
| 22 Jun 2026 | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | E | Standard survey | 4 Aug 2026 |
| 22 Jun 2026 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | Complaint investigation | 19 Apr 2026 |
| 22 Jun 2026 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | E | Complaint investigation | 15 Jun 2026 |
| 22 Jun 2026 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 4 Aug 2026 |
| 22 Jun 2026 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 12 Jun 2026 |
| 22 Jun 2026 | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard survey | 4 Aug 2026 |
| 22 Jun 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 4 Aug 2026 |
| 10 Dec 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | Past Non-Compliance |
| 10 Dec 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint investigation | Past Non-Compliance |
| 10 Dec 2025 | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | D | Complaint investigation | Past Non-Compliance |
| 6 Nov 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint investigation | 6 Dec 2025 |
| 11 Sep 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | Complaint investigation | 15 Oct 2025 |
| 11 Sep 2025 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0697 | Provide safe, appropriate pain management for a resident who requires such services. | G | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0759 | Ensure medication error rates are not 5 percent or greater. | E | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0554 | Allow residents to self-administer drugs if determined clinically appropriate. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0583 | Keep residents' personal and medical records private and confidential. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0699 | Provide care or services that was trauma informed and/or culturally competent. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0745 | Provide medically-related social services to help each resident achieve the highest possible quality of life. | D | Standard survey | 15 Oct 2025 |
| 11 Sep 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard survey | 15 Oct 2025 |
| 18 Jun 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | Complaint investigation | 18 Jul 2025 |
| 18 Jun 2025 | F0760 | Ensure that residents are free from significant medication errors. | E | Complaint investigation | 18 Jul 2025 |
| 18 Jun 2025 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Complaint investigation | 18 Jul 2025 |
| 26 Mar 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 25 Mar 2025 |
| 26 Mar 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint investigation | 30 Apr 2025 |
| 5 Mar 2025 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Complaint investigation | 4 Mar 2025 |
| 5 Mar 2025 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint investigation | 4 Mar 2025 |
| 5 Mar 2025 | F0678 | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | D | Complaint investigation | 4 Mar 2025 |
| 6 Aug 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 22 Aug 2024 |
| 10 Jul 2024 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Complaint investigation | 3 Aug 2024 |
| 10 Jul 2024 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Complaint investigation | 21 Jun 2024 |
| 15 May 2024 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | G | Standard survey | 13 Jun 2024 |
| 15 May 2024 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Standard survey | 13 Jun 2024 |
| 15 May 2024 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 13 Jun 2024 |
| 15 May 2024 | F0761 | 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. | D | Standard survey | 13 Jun 2024 |
| 15 May 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 13 Jun 2024 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 6 Nov 2025 | Fine | $70,720 | |
| 11 Sep 2025 | Fine | $42,705 | |
| 5 Mar 2025 | Fine | $8,112 | |
| 10 Jul 2024 | Fine | $11,333 | |
| 10 Jul 2024 | Fine | $8,018 | |
| 15 May 2024 | Fine | $12,695 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the South Dakota average. Turnover: nursing staff 76.1%, RNs 75.0%; 0 administrators left in the reporting year.
Quality measures
| Measure | Residents | This facility | South Dakota median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 28.8% | 20.7% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.4% | 1.7% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 7.6% | 2.2% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.6% | 4.8% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 7.1% | 1.5% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 34.8% | 19.6% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 5.5% | 3.9% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 30.2% | 22.4% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: for-profit, limited liability company. Legal business name: Arrowhead Sd Skilled Nursing Facility Llc. Chain: Legacy Healthcare (89 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Oakway Operations LLC | 5% or greater direct ownership interest | 15% | 07/01/2019 |
| Arrowhead Sd Property Holdings, LLC | 5% or greater security interest | NOT APPLICABLE | 07/01/2019 |
| Truist Bank | 5% or greater security interest | NOT APPLICABLE | 04/01/2022 |
| Legacy Healthcare Financial Services LLC | Operational/managerial control | NOT APPLICABLE | 07/01/2019 |
| Truist Bank | Operational/managerial control | NOT APPLICABLE | 04/01/2022 |
| Arrowhead Sd Property Holdings, LLC | Adp of the snf | NOT APPLICABLE | 07/01/2019 |
| Legacy Healthcare Financial Services LLC | Adp of the snf | NOT APPLICABLE | 11/10/2025 |
| Rsm Us LLP | Adp of the snf | NOT APPLICABLE | 01/01/2024 |
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Other nursing homes in Pennington County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Clarkson Health Care | Rapid City | 49 | 5 | 4 | 5 | 6 | 12.2 | — | 16 Apr 2026 |
| Westhills Village Health Care Facility | Rapid City | 44 | 5 | 4 | 4 | 11 | 25.0 | $9K | 12 Mar 2026 |
| Avantara North | Rapid City | 68 | 3 | 3 | 3 | 17 | 25.0 | $24K | 20 Feb 2026 |
| Fountain Springs Healthcare | Rapid City | 90 | 3 | 3 | 2 | 18 | 20.0 | $23K | 12 Feb 2026 |
| Avantara Mountain View | Rapid City | 101 | 2 | 2 | 3 | 22 | 21.8 | $9K | 2 Jul 2026 |
| Good Samaritan Society - St Martin Village | Rapid City | 60 | 2 | 2 | 4 | 19 | 31.7 | — | 4 Sep 2025 |
| Good Samaritan Society New Underwood | New Underwood | 41 | 2 | 2 | 3 | 29 | 70.7 | $27K | 8 Dec 2025 |
| Avantara Saint Cloudabuse icon | Rapid City | 78 | 1 | 2 | 1 | 17 | 21.8 | $25K | 18 Mar 2026 |
All 9 facilities in Pennington County
Questions and answers
How many deficiencies has Avantara Arrowhead been cited for?
45 health deficiencies across the three most recent survey cycles, 10 at the actual-harm or immediate-jeopardy level. The South Dakota median is 16 per facility.
Has Avantara Arrowhead been fined?
Yes. CMS lists fines totalling $154K in the period covered.
How does staffing at Avantara Arrowhead compare?
Reported total nurse staffing is 3.5 hours per resident per day against a South Dakota median of 3.6 and a national average of 3.9.
Who operates Avantara Arrowhead?
It is part of the Legacy Healthcare chain. Ownership type is for-profit, limited liability company. Organisations in the CMS ownership record include Oakway Operations LLC, Legacy Healthcare Financial Services LLC and Truist Bank. Individual owners and managers are not listed on this site.
When was Avantara Arrowhead last inspected?
The most recent survey or investigation in the CMS record is dated 22 Jun 2026; the most recent standard health survey was 22 Jun 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.