Avantara Arrowhead

2500 Arrowhead Dr · Rapid City, SD · 57702 · 6053480285

68 certified beds For profit - Limited Liability company Chain: Legacy Healthcare

Why this verdict

  • Carries CMS’s abuse warning icon.
  • Inspection record is far worse than the national median (deficiency count and severity).
  • Federal penalties on record: $93,163 in fines in the last 24 months.
  • Inspection results are getting worse cycle over cycle, not better.

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Red flags

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 abuse-related citation at the actual-harm level

Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.

5 actual-harm citations in the most recent cycle

Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.

$93,163 in federal fines in the last 24 months

4 fines — CMS fines are reserved for verified, serious non-compliance.

66% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 29
Serious harm & abuse 20% 40
Staffing 20% 61
Federal penalties 15% 17
Trend 10% 40
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 2 of 5

Total nurse hours / resident-day3.243.48 min · 4.1 strong
RN hours / resident-day0.780.55–0.75
Weekend hours / resident-day2.90≈ weekday level
Nursing turnover / year66%median 45%
Fines (3-yr window)5 · $105,858

Inspection citations (37 in the current record)

  • Potential for harm · D December 10, 2025 · found via complaint

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

    Past Non-Compliance · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D December 10, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Past Non-Compliance · Quality of Life and Care

  • Potential for harm · D December 10, 2025 · found via complaint

    Provide safe, appropriate pain management for a resident who requires such services.

    Past Non-Compliance · Quality of Life and Care

  • Actual harm · G November 6, 2025 · found via complaint

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

    Corrected December 6, 2025 · Quality of Life and Care

  • Actual harm · G September 11, 2025

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Corrected October 15, 2025 · Quality of Life and Care

  • Actual harm · G September 11, 2025

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

    Corrected October 15, 2025 · Quality of Life and Care

  • Actual harm · G September 11, 2025

    Provide safe, appropriate pain management for a resident who requires such services.

    Corrected October 15, 2025 · Quality of Life and Care

  • Actual harm · G September 11, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected October 15, 2025 · Quality of Life and Care

  • Potential for harm · D September 11, 2025

    Allow residents to self-administer drugs if determined clinically appropriate.

    Corrected October 15, 2025 · Resident Rights

  • Potential for harm · D September 11, 2025

    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 October 15, 2025 · Resident Rights

  • Potential for harm · D September 11, 2025

    Keep residents' personal and medical records private and confidential.

    Corrected October 15, 2025 · Resident Rights

  • Potential for harm · D September 11, 2025

    PASARR screening for Mental disorders or Intellectual Disabilities

    Corrected October 15, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D September 11, 2025

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected October 15, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E September 11, 2025

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected October 15, 2025 · Quality of Life and Care

  • Potential for harm · D September 11, 2025

    Provide care or services that was trauma informed and/or culturally competent.

    Corrected October 15, 2025 · Quality of Life and Care

  • Potential for harm · D September 11, 2025

    Provide medically-related social services to help each resident achieve the highest possible quality of life.

    Corrected October 15, 2025 · Quality of Life and Care

  • Potential for harm · E September 11, 2025

    Ensure medication error rates are not 5 percent or greater.

    Corrected October 15, 2025 · Pharmacy Service

  • Potential for harm · E September 11, 2025

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

    Corrected October 15, 2025 · Nutrition and Dietary

  • Potential for harm · D September 11, 2025

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected October 15, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E September 11, 2025

    Provide and implement an infection prevention and control program.

    Corrected October 15, 2025 · Infection Control

  • Potential for harm · D June 18, 2025 · found via complaint

    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

    Corrected July 18, 2025 · Resident Rights

  • Potential for harm · E June 18, 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 July 18, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · E June 18, 2025 · found via complaint

    Ensure that residents are free from significant medication errors.

    Corrected July 18, 2025 · Pharmacy Service

  • Potential for harm · D March 26, 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 March 25, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D March 26, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected April 30, 2025 · Quality of Life and Care

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
September 11, 2025Fine$65,700
March 5, 2025Fine$8,112
July 10, 2024Fine$8,018
July 10, 2024Fine$11,333
May 15, 2024Fine$12,695

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 435051 · certified since January 1, 1991. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.