CCN 435058 · Clark County, South Dakota
Avantara Clark City
201 8th Avenue NW, Clark, SD 57225
Avantara Clark City is a 35-bed for-profit nursing home in Clark, South Dakota, first certified for Medicare or Medicaid in 1991. CMS rates it 4 out of 5 stars overall in its September 2026 data, and it averaged 29.3 residents a day, about 84% of its certified beds. We found no FHA-insured Section 232 loan for it in HUD's healthcare endorsement database (fiscal 2001 onward).
Facility facts
- Certified beds
- 35
- Average residents per day
- 29.3 (83.7% of beds)
- Ownership type
- For profit - Limited Liability company
- Certification
- Medicare and Medicaid
- Legal business name
- Clark City Sd Skilled Nursing Facility LLC
- Certified since
- May 1, 1991
- Chain or affiliated group
- Legacy Healthcare (95 facilities, chain average 2.9 stars)
- Location
- Rural
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | South Dakota median | US median |
|---|---|---|---|
| Overall rating | 4 of 5 | State spread: 19 at 1, 22 at 2, 18 at 3, 16 at 4, 19 at 5 | |
| Health inspections | 4 of 5 | ||
| Quality measures | 2 of 5 | ||
| Staffing | 2 of 5 | ||
| Total nurse hours per resident per day | 4.17 | 3.62 | 3.68 |
| RN hours per resident per day | 0.73 | 0.76 | 0.58 |
| Weekend nurse hours per resident per day | 3.49 | ||
| Nursing staff turnover | 42.4% | 46.6% | 44.9% |
| Occupancy (residents / beds) | 83.7% | 90.3% | 85.7% |
| Fines reported by CMS | 1 totaling $11,057 | ||
| Health deficiencies, latest standard survey | 3 (Jan 8, 2026) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Avantara Clark City meets that part today: 4 stars overall, 4 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| Doros Generation Trust U/a/D 1/3/12Organization | Direct Ownership Interest | 43% | 07/01/2019 |
| Gpn Family Trust U/a/D 4/28/08Organization | Direct Ownership Interest | 43% | 07/01/2019 |
| Oakway Operations LLCOrganization | Direct Ownership Interest | 15% | 07/01/2015 |
| Bokf,naOrganization | Security Interest | n/a | 03/04/2024 |
| Bokf,naOrganization | Operational / Managerial Control | n/a | 03/04/2024 |
| Dickes, EdwardIndividual | Operational / Managerial Control | n/a | 01/01/2025 |
| Morehouse, RachelIndividual | Operational / Managerial Control | n/a | 01/06/2020 |
| Rajchenbach, ChaimIndividual | Operational / Managerial Control | n/a | 07/01/2019 |
| Shabat, MenachemIndividual | Operational / Managerial Control | n/a | 07/01/2019 |
Changes of ownership
| Effective | Buyer | Seller |
|---|---|---|
| Jul 1, 2019 | Clark City Sd Skilled Nursing Facility LLC | Clark Care and Rehabilitation Center LLC |
HUD Section 232 loans
No FHA-insured loan matching this facility appears in HUD's database of healthcare endorsements, which covers fiscal 2001 onward (HUD data run of July 8, 2026). A loan could still exist under a different project name or from before 2001.
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.