Avantara Norton
3600 South Norton Avenue · Sioux Falls, SD · 57105 · 6053389891
110 certified beds For profit - Limited Liability company Chain: Legacy Healthcare
Why this verdict
- On the federal Special Focus list of the most persistently poor performers.
- Carries CMS’s abuse warning icon.
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $75,446 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
Special Focus Facility
CMS has designated this facility one of the most persistently poor performers in the country — it is under increased inspection and enforcement.
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
1 immediate-jeopardy citation in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
Cited under the freedom-from-abuse rule
Cited 3 times under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
9 actual-harm citations in the most recent cycle
Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.
$75,446 in federal fines in the last 24 months
3 fines — CMS fines are reserved for verified, serious non-compliance.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: not rated Inspections: not rated Staffing: not rated Quality measures: not rated
| Total nurse hours / resident-day | 3.73 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.64 | 0.55–0.75 |
| Weekend hours / resident-day | 3.15 | ≈ weekday level |
| Nursing turnover / year | 59% | median 45% |
| Fines (3-yr window) | 6 · $153,638 |
Inspection citations (75 in the current record)
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Actual harm · G March 31, 2026 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected May 8, 2026 · Quality of Life and Care
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Actual harm · G March 31, 2026
Provide safe, appropriate pain management for a resident who requires such services.
Corrected May 8, 2026 · Quality of Life and Care
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Actual harm · G March 31, 2026
Ensure that residents are free from significant medication errors.
Corrected May 8, 2026 · Pharmacy Service
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Actual harm · G March 31, 2026 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected May 8, 2026 · Quality of Life and Care
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Actual harm · G March 31, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 8, 2026 · Quality of Life and Care
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Potential for harm · D March 31, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected May 8, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 31, 2026 · found via complaint
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Corrected December 10, 2025 · Quality of Life and Care
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Potential for harm · D March 31, 2026
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.
Corrected May 8, 2026 · Resident Rights
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Potential for harm · E March 31, 2026
Ensure each resident receives an accurate assessment.
Corrected May 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · E March 31, 2026
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected May 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · D March 31, 2026
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected May 8, 2026 · Nutrition and Dietary
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Potential for harm · D March 31, 2026
Provide and implement an infection prevention and control program.
Corrected May 8, 2026 · Infection Control
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Potential for harm · D March 31, 2026 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected May 8, 2026 · Resident Rights
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Potential for harm · E March 31, 2026 · found via complaint
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected May 8, 2026 · Resident Rights
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Potential for harm · E March 31, 2026 · found via complaint
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.
Corrected May 8, 2026 · Quality of Life and Care
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Actual harm · G February 4, 2026 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected January 16, 2026 · Quality of Life and Care
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Actual harm · G February 4, 2026 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected March 6, 2026 · Quality of Life and Care
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Actual harm · G February 4, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected March 6, 2026 · Quality of Life and Care
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Potential for harm · D December 30, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Past Non-Compliance · Quality of Life and Care
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Potential for harm · D December 30, 2025 · found via complaint
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Past Non-Compliance · Nutrition and Dietary
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Potential for harm · E November 14, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected December 12, 2025 · Infection Control
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Actual harm · G July 10, 2025 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected May 1, 2025 · Quality of Life and Care
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Potential for harm · D July 10, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected May 28, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D July 10, 2025 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected August 4, 2025 · Resident Assessment and Care Planning
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Potential for harm · D July 10, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 7, 2025 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| March 5, 2025 | Fine | $51,376 |
| September 26, 2024 | Fine | $12,035 |
| July 17, 2024 | Fine | $12,035 |
| June 20, 2024 | Fine | $12,035 |
| March 13, 2024 | Fine | $37,557 |
| October 4, 2023 | Fine | $28,600 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 435039 · certified since April 1, 1989. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.