Home / South Dakota / Clark
201 8th Avenue Nw, Clark, SD 57225 · Clark County · (605) 532-3431
35 certified beds, about 29 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1991
CMS Care Compare ratings, data as of September 1, 2026 · CCN 435058 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on January 8, 2026, inspectors cited 3 health deficiencies (the South Dakota average is 6.7, the national average 9.2).
Of 7 health citations since June 2023, 1 was rated as actual harm or immediate jeopardy to residents.
CMS lists 1 fine totaling $11,057 in the last three years; the largest was $11,057, and the latest is dated September 12, 2024.
Nurses and nurse aides worked 4.17 hours per resident per day, against 3.79 across South Dakota and 3.86 nationally. Registered nurses accounted for 0.73 of those hours.
42.4% of nursing staff left within the year CMS measured (South Dakota average 48.2%).
CMS links it to Legacy Healthcare, an affiliated group of 95 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 7 health citations on file.
Inspectors wroteBased on record review, interview, observation, document review, South Dakota Department of Health (SD DOH) facility reported incidents (FRI), and policy review, the provider failed to ensure: *An environment was free of flammable materials where two of two sampled resdients (2 and 26) were observed smoking. *Assistive devices were used for one of one 1 sampled resident (2) who used cigarette holders to prevent a burn. *Appropriate supervision for one of three sampled resident (26) while smoking. *Facility exit and interior doors functioned appropriately, and staff were re-educated as stated in the corrective actions in the 11/16/25 and 11/26/25 FRI regarding one of one closed sampled resident (37) who eloped outside and entered a room where chemicals were stored.
Inspectors wroteBased on observation, interview, and policy review, the provider failed to ensure the staff followed infection control practices regarding: *Foley catheters (flexible tubing placed in the bladder to drain urine), tubing and urinary drainage bag placement for two of two sampled residents with foley catheter. *Hand hygiene by one of one registered nurse (RN) D observed administering medications to multiple residents during a noon meal service without sanitizing her hands in between each resident's medication administrations.*One of one certified nursing assistant (CNA) (F) observed without wearing a gown and gloves when transferring a resident (26) on enhanced barrier precautions (EBP), and did not clean the lift after transferring the resident.
Inspectors wroteBased on record review, interview, and policy review, the provider failed to report to the South Dakota Department of Health (SD DOH) that one of one sampled residents (2) received cigarette burns to his fingers.
Inspectors wroteBased on South Dakota Department of Health (SD DOH) facility-reported incident (FRI), record review, interview, and policy review, the provider failed to provide adequate supervision and assistance to ensure the safety of one of one sampled resident (1) who fell while being transferred by certified nursing assistant (CNA) C who did not transfer the resident as directed in the resident's care plan and did not report the incident as a fall to the nurse for timely and appropriate assessment of the resident. This citation is considered past non-compliance based on a review of the provider's corrective actions immediately following the incident.
Inspectors wroteBased on interview, observation, and record review, the provider failed to ensure a bed frame was maintained and free of hazardous sharp areas for one of one sampled resident (1) who acquired a skin tear to her right lower outer ankle.
Inspectors wroteBased on record review, interview and policy review the provider failed to ensure the 48 hour nutritional care plans for two of four sampled residents (11 and 22) were updated in their comprehensive care plan.
Inspectors wroteBased on observation, interview and record review the provider failed to ensure quarterly side rail assessments were completed for three of seven residents (4, 5, and 19). 1. Observation on 6/14/23 at 9:00 a.m. of resident 5's room revealed she had a one-half side rail on the left side of her bed. Interview on 6/14/23 at 9:30 a.m. with maintenance director E revealed: *He stated the assessments had been completed in the four months since he began working at this facility. *He provided documentation of a side rail audit with one bed rail audit conducted on 5/30/23 for room [ROOM NUMBER] which was not resident 5's room. *He admitted that he had not done as many assessments as he thought. Interview on 6/14/23 at 3:34 p.m. with director of nursing A and Minimum Data Set coordinator F regarding resident 5's side rails revealed: [...]
11 fire safety citations on file: 4 on January 8, 2026, 7 on June 15, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| September 12, 2024 | Fine | $11,057 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | South Dakota | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 4.17 | 3.79 | 3.86 |
| Registered nurses | 0.73 | 0.80 | 0.69 |
| All nursing staff on weekends | 3.49 | 3.26 | 3.42 |
| Nurse aides | 2.72 | ||
| Licensed practical nurses | 0.72 | ||
| Nursing staff turnover (share who left in a year) | 42.4% | 48.2% | 45.8% |
| Registered nurse turnover | 40.0% | 34.7% | 42.9% |
| Administrators who left | 0 |
CMS expects 5.22 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.44 on weekdays and 3.49 on weekends, 21% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 8.6% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.89 in April to June 2025 to 4.17 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 4.17 | 0.73 | 4.44 | 3.49 | 8.6% | 0 of 90 | 29 |
| Oct to Dec 2025 | 3.95 | 0.72 | 4.16 | 3.43 | 9.6% | 0 of 92 | 30 |
| Jul to Sep 2025 | 3.98 | 0.78 | 4.21 | 3.40 | 6.8% | 0 of 92 | 29 |
| Apr to Jun 2025 | 3.89 | 0.76 | 4.14 | 3.27 | 10.3% | 0 of 91 | 31 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| South Dakota, Jan to Mar 2026 | 3.76 | 0.79 | 3.97 | 3.25 | 9.1% | 1.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| South Dakota, all employers | |||
| CNAs (nursing assistants) | $18.65 | $17.71 to $21.12 | 6,860 |
| LPNs and LVNs | $25.36 | $23.88 to $29.47 | 2,050 |
| Registered nurses | $37.53 | $31.29 to $40.52 | 14,710 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | South Dakota | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 31.8 | 21.4 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 4.5 | 2.1 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 4.0 | 2.9 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 4.9 | 5.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 2.0 | 2.0 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 18.6 | 19.4 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.3 | 4.6 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 29.3 | 24.6 | 15.4 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Avantara Clark City's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (51.2% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
51.2% this home
No different from the national rate
US median of homes 51.5% · South Dakota: 7 better, 10 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 25 eligible stays.
10.2% this home
No different from the national rate
US median of homes 10.7% · South Dakota: 0 better, 0 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 34 eligible stays.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
US median of homes 7.1% · South Dakota: 0 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 24 eligible stays.
31.8% this home
Median of homes: South Dakota52.7% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 22 residents counted.
11.5% this home
Median of homes: South Dakota1.1% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 26 residents counted.
3.5% this home
Median of homes: South Dakota2.5% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 26 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: South Dakota100.0% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 7 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: CLARK CITY SD SKILLED NURSING FACILITY LLC. CMS links this home to Legacy Healthcare, a group of 95 nursing homes averaging 2.9 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Doros Generation Trust U/a/D 1/3/12 | 5% or greater direct ownership interest | Organization | 43% | 07/01/2019 |
| Gpn Family Trust U/a/D 4/28/08 | 5% or greater direct ownership interest | Organization | 43% | 07/01/2019 |
| Oakway Operations LLC | 5% or greater direct ownership interest | Organization | 15% | 07/01/2015 |
| Bokf,na | 5% or greater security interest | Organization | 03/04/2024 | |
| Rajchenbach, Chaim | Managing control - governing body | Individual | 07/01/2019 | |
| Shabat, Menachem | Managing control - governing body | Individual | 07/01/2019 | |
| Bokf,na | Operational/managerial control | Organization | 03/04/2024 | |
| Dickes, Edward | Operational/managerial control | Individual | 01/01/2025 | |
| Morehouse, Rachel | Operational/managerial control | Individual | 01/06/2020 | |
| Rajchenbach, Chaim | Operational/managerial control | Individual | 07/01/2019 | |
| Shabat, Menachem | Operational/managerial control | Individual | 07/01/2019 | |
| Clark City Sd Property Holdings, LLC | Adp of the SNF | Organization | 07/01/2019 | |
| Doros Generation Trust U/a/D 1/3/12 | Adp of the SNF | Organization | 07/01/2019 | |
| Gpn Family Trust U/a/D 4/28/08 | Adp of the SNF | Organization | 07/01/2019 | |
| Legacy Healthcare Financial Services LLC | Adp of the SNF | Organization | 07/01/2019 | |
| Roth & Co, LLP | Adp of the SNF | Organization | 01/01/2024 | |
| Dickes, Edward | Adp of the SNF | Individual | 01/01/2025 | |
| Morehouse, Rachel | Adp of the SNF | Individual | 01/06/2020 | |
| Rajchenbach, Chaim | Adp of the SNF | Individual | 07/01/2019 | |
| Shabat, Menachem | Adp of the SNF | Individual | 07/01/2019 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in South Dakota. NursingHomeClear cannot take or act on complaints.