CCN 435068 · Codington County, South Dakota
Avantara Watertown
415 Fourth Ave NE, Watertown, SD 57201
Avantara Watertown is a 51-bed for-profit nursing home in Watertown, South Dakota, first certified for Medicare or Medicaid in 1993. CMS rates it 1 out of 5 stars overall in its September 2026 data, and it averaged 46.6 residents a day, about 91% 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
- 51
- Average residents per day
- 46.6 (91.4% of beds)
- Ownership type
- For profit - Limited Liability company
- Certification
- Medicare and Medicaid
- Legal business name
- Watertown Sd Skilled Nursing Facility, LLC
- Certified since
- Mar 1, 1993
- 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 | 1 of 5 | State spread: 19 at 1, 22 at 2, 18 at 3, 16 at 4, 19 at 5 | |
| Health inspections | 1 of 5 | ||
| Quality measures | 2 of 5 | ||
| Staffing | 3 of 5 | ||
| Total nurse hours per resident per day | 3.57 | 3.62 | 3.68 |
| RN hours per resident per day | 1.06 | 0.76 | 0.58 |
| Weekend nurse hours per resident per day | 2.87 | ||
| Nursing staff turnover | 44.2% | 46.6% | 44.9% |
| Occupancy (residents / beds) | 91.4% | 90.3% | 85.7% |
| Fines reported by CMS | 3 totaling $71,591 | ||
| Health deficiencies, latest standard survey | 26 (Apr 29, 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 Watertown does not meet it today: overall rating 1, health inspection rating 1, the 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% | 07/01/2019 |
| Truist BankOrganization | Security Interest | n/a | 04/01/2022 |
| Watertown Sd Property Holdings, LLCOrganization | Security Interest | n/a | 07/01/2019 |
| Truist BankOrganization | Operational / Managerial Control | n/a | 04/01/2022 |
| Rajchenbach, ChaimIndividual | Operational / Managerial Control | n/a | 07/01/2019 |
| Shabat, MenachemIndividual | Operational / Managerial Control | n/a | 07/01/2019 |
| Shives, AaronIndividual | Operational / Managerial Control | n/a | 07/01/2019 |
| Speier, LynnaIndividual | Operational / Managerial Control | n/a | 10/01/2025 |
Changes of ownership
| Effective | Buyer | Seller |
|---|---|---|
| Jul 1, 2019 | Watertown Sd Skilled Nursing Facility, LLC | Watertown 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.