Nursing homeActive
Avantara Pierre
950 East Park Street, Pierre, SD 57501605224862865 certified beds · 59 residentsFor profit - Limited Liability companyMedicare and Medicaid
Surveys on file
4
since 2024
Deficiencies
36
● 0● 33● 3
Penalties · 3 yrs
$22,048
1 fine
Last survey
2026-07-01
Standard
CMS overall
2 / 5
stars as published by CMS
CMS overall 2/5
Health 2
Staffing 3
Quality 2
Star ratings as published by CMS · CMS’s caveats
Survey history
Source: CMS · South Dakota Department of Health · data as of 2026-08-01| Date | Kind | Deficiencies | Official record | Archived PDF |
|---|---|---|---|---|
| 2026-07-01 | Standard | 0111 | CMS-2567 (Care Compare) | — |
| 2025-05-07 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2025-04-02 | Standard | 072 | CMS-2567 (Care Compare) | — |
| 2024-01-09 | Standard | 0140 | CMS-2567 (Care Compare) | — |
Counts by class: paperwork · standard · harm.
Deficiencies
CMS · South Dakota Department of Health publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity GHarm
Care planningFalls
Isolated; actual harm that is not immediate jeopardy.Corrected 2026-08-01Record 435047-20260701-F689
F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F550
F554Allow residents to self-administer drugs if determined clinically appropriate.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F554
F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-04-17Record 435047-20260701-F600
F638Assure that each resident’s assessment is updated at least once every 3 months.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F638
F658Ensure services provided by the nursing facility meet professional standards of quality.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F658
F699Provide care or services that was trauma informed and/or culturally competent.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F699
F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F740
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F755
F761Ensure 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.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F761
F880Provide and implement an infection prevention and control program.Scope/severity EStandard
Infection control
Pattern; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F880
F919Make sure that a working call system is available in each resident's bathroom and bathing area.Scope/severity DStandard
Environment
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-08-01Record 435047-20260701-F919
F697Provide safe, appropriate pain management for a resident who requires such services.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-04-24Record 435047-20250507-F697
F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Scope/severity GHarm
Abuse & neglect
Isolated; actual harm that is not immediate jeopardy.Corrected 2025-05-01Record 435047-20250402-F600
F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Scope/severity GHarm
Care planning
Isolated; actual harm that is not immediate jeopardy.Corrected 2025-05-01Record 435047-20250402-F686
F554Allow residents to self-administer drugs if determined clinically appropriate.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F554
F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Scope/severity EStandard
Dignity & rights
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F584
F625Notify 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.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F625
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F656
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity DStandard
Care planningFalls
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F689
F847Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.Scope/severity FStandard
Records
Widespread; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F847
F880Provide and implement an infection prevention and control program.Scope/severity EStandard
Infection control
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-05-01Record 435047-20250402-F880
F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F561
F625Notify 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.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F625
F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedScope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F655
F678Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-01-04Record 435047-20240109-F678
F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F684
F692Provide enough food/fluids to maintain a resident's health.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F692
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F695
F732Post nurse staffing information every day.Scope/severity EStandard
Staffing
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F732
F761Ensure 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.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F761
F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F803
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity FStandard
Food & nutrition
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F812
F835Administer the facility in a manner that enables it to use its resources effectively and efficiently.Scope/severity FStandard
Records
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F835
F849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.Scope/severity FStandard
Records
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F849
F865Have a plan that describes the process for conducting QAPI and QAA activities.Scope/severity FStandard
Records
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-02-20Record 435047-20240109-F865
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2025-04-02 | Civil money penalty | $22,048 | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day0.60
Facility
South Dakota
National
South Dakota 0.80 · National 0.69
Total nurse hours per resident day2.81
Facility
South Dakota
National
South Dakota 3.79 · National 3.86
Weekend total nurse hours2.28
Facility
South Dakota
National
South Dakota 3.26 · National 3.42
Total nursing staff turnover41%
Facility
South Dakota
National
South Dakota 48% · National 46%
Registered nurse turnover14%
Facility
South Dakota
National
South Dakota 35% · National 43%
Quality measures
CMS MDS quality measures · 2025Q2-2026Q1 · definitions| Measure | Facility | South Dakota | National |
|---|---|---|---|
| Percentage of long-stay residents with pressure ulcers lower is better | 8.9% | 4.6% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 5.5% | 5.5% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 12.8% | 24.6% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 5.3% | 2.9% | 1.6% |
| Percentage of long-stay residents who were physically restrained lower is better | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose need for help with daily activities has increased lower is better | 27.8% | 21.3% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 5.1% | 5.6% | 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication lower is better | 6.5% | 17.4% | 19.5% |
Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.
Ownership
As reported to CMS (Provider Enrollment)| Entity | Role | Interest | Since | Registry |
|---|---|---|---|---|
| Doros Generation Trust U/A/D 1/3/12 Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | — | — |
| Gpn Family Trust U/A/D 4/28/08 Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 43% | — | — |
| Oakway Operations LLC Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 15% | — | — |
| Plumage, Darrell Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Rajchenbach, Chaim Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Shabat, Menachem Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Truist Bank Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Watson, Chase Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Doros Generation Trust U/A/D 1/3/12 Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Gpn Family Trust U/A/D 4/28/08 Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Legacy Healthcare Financial Services LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Pierre Sd Property Holdings, LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Pierre Sd Property Holdings, LLC Organization | 5% OR GREATER SECURITY INTEREST | NOT APPLICABLE | — | — |
| Plumage, Darrell Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Rajchenbach, Chaim Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Rajchenbach, Chaim Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Roth & Co, LLP Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Shabat, Menachem Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Shabat, Menachem Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Truist Bank Organization | 5% OR GREATER SECURITY INTEREST | NOT APPLICABLE | — | — |
| Watson, Chase Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
Part of a chain
Legacy Healthcare — 89 facilities
Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.
Cost context
County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or South Dakota.
No county cost figures on file for Hughes.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| Avera Maryhouse Long Term Care Pierre | 0.1 mi | 2025-09-11 | 060 |
| Avera Oahe Manor Gettysburg | 49.2 mi | 2025-09-04 | 090 |
| White River Health Care Center White River | 58.0 mi | 2025-03-27 | 011 |
| Highmore Health Highmore | 45.7 mi | 2026-01-21 | 0160 |
| Medicine Wheel Village Eagle Butte | 62.3 mi | 2026-03-25 | 0231 |
Watch this facility
One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.
Sources & provenance
| Section | Agency · dataset | Retrieved |
|---|---|---|
| Facility, ratings | CMS Provider Data · Nursing Home Provider Information | 2026-08-01 |
| Surveys | CMS · Survey Summary | 2026-08-01 |
| Deficiencies | CMS · Health Deficiencies (CMS-2567 findings via Care Compare) | 2026-08-01 |
| Penalties | CMS · Penalties | 2026-08-01 |
| Staffing | CMS · Payroll-Based Journal (PBJ, as published Aug 2026) | 2026-08-01 |
| Quality measures | CMS · MDS Quality Measures | 2026-08-01 |
| Ownership | CMS · Ownership | 2026-08-01 |