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Nursing HomeMedicaid Investigative

Avantara Milbank

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

1103 South Second Street, Milbank, SD 5725255 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
4.5/5

based on 8 Google reviews

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5/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (1/5 stars)
  • Low staffing rating (2/5 stars)
  • High staff turnover (82%)
  • High RN turnover (77%)

Bottom 25% in SD · Meets national RN staffing standard · Very high staff turnover · Worst in LEGACY HEALTHCARE chain · $55,361 in fines

Source: Medicare data

What this means for your family

While the facility received high praise in 2019, the most recent review from 2023 raises severe concerns regarding medical oversight and communication during health crises. If you are considering this facility, I strongly advise asking for specific protocols on how the nursing team escalates medical concerns to families and physicians, and verifying their current staffing ratios.

Google Reviews

Google Reviews

8 reviews on Google
Avantara Milbank has a significant disparity in feedback, with older reviews from 2019 praising the staff as caring and respectful, while a more recent 2023 review reports severe neglect regarding medical care. The facility faces critical allegations concerning delayed communication and failure to provide timely medical intervention for a resident in distress.

Quality Themes

Tap a score for details
FoodN/AStaff6.0CleanN/AActivitiesN/AMeds1.0MemoryN/AComms2.0ValueN/A

Strengths

  • Historically praised for respectful staff
  • Long-term resident satisfaction
  • Responsive management to positive feedback

Concerns

  • Failure to provide timely medical intervention and communication

Rating Trends

Tap a year to see what changed

2345.02019(6)5.02020(2)1.02023(1)

Distribution · 9 analyzed

5
8
4
0
3
0
2
0
1
1

How They Respond to Reviews

88%response rate

This facility actively engages with reviewer feedback.

Questions for Your Tour

  • 1It's great to see how much management engages with the community feedback; how do you typically incorporate family suggestions into your daily operations?
  • 2What is the specific process for ensuring medications are administered accurately and on schedule every day?
  • 3In the event of a sudden change in a resident's health, what are the immediate steps the nursing staff takes to ensure timely medical intervention?
  • 4How does the nursing team ensure that families are kept updated and informed about any changes in a resident's condition or care plan?
  • 5What kind of daily activities or social outings do you have planned to keep the residents engaged and connected with one another?
  • 6With a smaller, intimate community of 55 residents, how do you ensure that every person's specific care needs are being closely monitored by the staff?

Personalized based on this facility's data


Key Review Excerpts

If you care about your loved ones, do not put them here. My great grandmother was placed here. We got a phone call several days into her fighting influenza A, but not until after she was unresponsive and purple from the knees down.

Great-granddaughter of a resident · 2023☆☆☆☆

Our relatives were given extra ordinary care while they were there. Great place and great service.

Family member of former residents · 2019★★★★★

Excellent staff!! Very caring and respectful!

Visitor or family member · 2019★★★★★
Source: 8 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.98hrs
OK
Registered nurses for medical care
Total Nursing
3.00hrs
73%
All nurses + aides combined
Staff Turnover
86%
Lower is better (< 30% = good)
RN Turnover
88%
Lower is better (< 30% = good)

Total nursing hours are below minimum, though RN coverage is adequate. This may mean fewer aides for daily tasks like bathing and mobility.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 16 measures

Medicare Rating
2/ 5
Better Than Avg

3

measures

Worse Than Avg

11

measures

Mixed Results

2

measures

Long-Stay Residents
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility33.0%
Worse than Avg
Here
33.0%
US
14.4%
SD
21.4%
Grant
16.6%
😔

Residents with depression symptoms

↓ Lower is better
This Facility23.5%
Worse than Avg
Here
23.5%
US
12.1%
SD
5.3%
Grant
10.1%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

🚶

Residents whose walking got worse

↓ Lower is better
This Facility32.3%
Worse than Avg
Here
32.3%
US
15.3%
SD
20.2%
Grant
15.3%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility82.2%
Worse than Avg
Here
82.2%
US
93.4%
SD
95.2%
Grant
92.6%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility26.1%
Worse than Avg
Here
26.1%
US
15.5%
SD
24.5%
Grant
19.8%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility25.6%
Worse than Avg
Here
25.6%
US
19.5%
SD
17.5%
Grant
21.1%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility52.8%
Worse than Avg
Here
52.8%
US
81.8%
SD
82.7%
Grant
79.5%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility6.5%
Worse than Avg
Here
6.5%
US
1.6%
SD
1.9%
Grant
1.5%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

4deficiencies
3penalties
Near state avg (6.8)
8 complaint-triggered
$55,361 in fines

Multiple families have filed complaints triggering inspections, with concerning issues found in abuse/neglect reporting, medication management, and daily care assistance. The facility shows recurring problems with safety (exit obstructions), resident rights, and quality of care across recent surveys. While all deficiencies have reported correction dates, the pattern of complaint-driven investigations and repeated violations in critical care areas warrants careful consideration during any visit.

Mar 13, 2025Routine
8
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0211Potential for harm · Pattern

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0675Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Honor each resident's preferences, choices, values and beliefs.

0623Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

0625Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0351Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install an approved automatic sprinkler system.

0712Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0741Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Mar 13, 2025Complaint
1
0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

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

Dec 18, 2024Complaint
3
0760Actual harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0585Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0609Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

Oct 8, 2024Complaint
3
0609Actual harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

0610Actual harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0692Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

Aug 6, 2024Complaint
1
0677Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

Nov 8, 2023Routine
8
0658Actual harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0689Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0712Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0550Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0656Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0211Potential for harm · IsolatedCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0363Minimal · WidespreadCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

Federal Penalties

Fine

Dec 18, 2024

$28,912

Fine

Oct 8, 2024

$15,041

Fine

Nov 8, 2023

$11,408

Ownership & Operations

Who Operates This Facility

Owner / Operator

Avantara Milbank

Organization Type

for profit

Chain Affiliation

Chain Name

Legacy Healthcare

Chain Size

89 facilities nationwide

Chain avg rating: 3.0/5 · Rank 83 of 89 (Worst)

Ownership & Management

Owners

Doros Generation Trust U/a/d 1/3/12

Owner · Organization

43%

Gpn Family Trust U/a/d 4/28/08

Owner · Organization

43%

Oakway Operations LLC

Owner · Organization

15%

Key personnel

Milbank Sd Property Holdings, LLC5% or Greater Security InterestTruist Bank5% or Greater Security InterestRajchenbach, ChaimManaging Control - Governing BodyShabat, MenachemManaging Control - Governing BodyTruist BankManager
Source: Medicare provider data

Contact

Get in Touch

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References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 1 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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