Avantara Arrowhead: Staffing, Turnover, and Inspection Record
Avantara Arrowhead is a 68-bed for-profit nursing home in Rapid City, South Dakota, part of Legacy Healthcare. In the CMS August 2026 release it reported 2.23 nurse aide hours per resident per day, 11% below the South Dakota average of 2.52, and 76.1% nursing staff turnover (South Dakota average 48.2%).
Avantara Arrowhead
2500 Arrowhead DrRapid City, SD 57702
Pennington County
CMS Care Compare, August 2026 release
Cited for abuse or neglect. CMS marks this home with its abuse icon: it was cited for abuse or neglect that caused harm on its most recent inspection cycle, or for abuse or neglect with potential for harm on each of its last two cycles.
How many staff hours residents get
CMS reports staffing as hours per resident per day, from the payroll records each home submits. At Avantara Arrowhead, nurse aides logged 2.23 hours per resident per day, 11% below the South Dakota average. With about 59 residents a day, that works out to roughly 133 aide hours a day, or about 17 eight-hour aide shifts across day, evening, and night. On weekends, total nursing hours per resident ran 7% below the all-days figure.
| Hours per resident per day | This home | South Dakota avg | US avg |
|---|---|---|---|
| Nurse aides (CNAs) | 2.23 | 2.52 | 2.32 |
| Licensed practical nurses | 0.30 | 0.47 | 0.86 |
| Registered nurses | 0.98 | 0.80 | 0.69 |
| All nursing staff | 3.52 | 3.79 | 3.86 |
| All nursing staff, weekends | 3.27 | 3.26 | 3.42 |
CMS Care Compare, August 2026 release: reported staffing hours from Payroll-Based Journal data, and CMS state and US averages.
Staff turnover
76.1% of nursing staff at Avantara Arrowhead left over the year CMS measured, against a South Dakota average of 48.2% and a US average of 45.8%. Registered nurse turnover was 75.0%. No administrators left over the same period.
Inspections and penalties
State inspectors last completed a standard health inspection on Jun 22, 2026. The most recent inspection cycle, which also counts complaint and infection-control inspections from the past 12 months, found 13 health deficiencies (South Dakota average 6.9). CMS lists 6 fines totaling $153,583 in the last three years.
| Inspection date | Penalty | Amount or length |
|---|---|---|
| Nov 6, 2025 | Fine | $70,720 |
| Sep 11, 2025 | Fine | $42,705 |
| Mar 5, 2025 | Fine | $8,112 |
| Jul 10, 2024 | Fine | $8,018 |
| Jul 10, 2024 | Fine | $11,333 |
| May 15, 2024 | Fine | $12,695 |
CMS Penalties file, August 2026 release. A payment denial stops Medicare and Medicaid payment for new admissions for the days shown.
CMS star ratings
CMS rates every nursing home from one to five stars overall and on health inspections, staffing, and quality measures. Avantara Arrowhead holds 1 of 5 overall; the South Dakota average is 2.9.
About Avantara Arrowhead
- Ownership: For profit - Limited Liability company
- Chain: Legacy Healthcare, 89 homes
- Legal name: Arrowhead SD Skilled Nursing Facility LLC
- Medicare and Medicaid certified since: Jan 1, 1991
- Councils: resident and family councils
- Area: urban
Nursing homes near Avantara Arrowhead
The closest homes by distance, with the same CMS figures. Select a column to sort.
| Clarkson Health Care Rapid City | 0.5 | 49 | 2.40 | 4.20 | 34.0% | 5 | None |
| Avantara Mountain View Rapid City | 1.5 | 101 | 2.40 | 3.61 | 41.4% | 2 | $9,318 |
| Avantara Saint Cloud Rapid City · abuse citation | 2.1 | 78 | 2.15 | 3.12 | 57.3% | 1 | $24,751 |
| Westhills Village Health Care Facility Rapid City | 2.6 | 44 | 2.10 | 3.70 | 46.2% | 5 | $8,788 |
| Fountain Springs Healthcare Rapid City | 3.2 | 90 | 2.12 | 3.79 | 53.7% | 3 | $22,526 |
| Avantara North Rapid City | 3.4 | 68 | 1.86 | 3.06 | 35.4% | 3 | $24,108 |
| Good Samaritan Society - St Martin Village Rapid City | 3.4 | 60 | 2.04 | 3.73 | 60.0% | 2 | None |
| Good Samaritan Society New Underwood New Underwood | 22.0 | 41 | 1.62 | 2.82 | 64.7% | 2 | $26,595 |
Aide hrs and all nurse hrs are staff hours per resident per day. Fines are the CMS total for the last three years. Turnover is the share of nursing staff who left over a year. All figures from CMS Care Compare.
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Source: CMS Care Compare Provider Information, State and US Averages, and Penalties files, August 2026 release. Figures are as CMS publishes them; check Medicare Care Compare for the latest. Methodology.