Avantara Arrowhead: Accident Hazard Harm - SD
Federal inspectors cited the facility for causing actual harm to residents after reviewing the lift system's operating manual, dated October 2020. The language was direct. All residents must always be securely safety belted at the waist when using any of the lift systems, the manual stated on page seven. Not sometimes. Not when circumstances allow. Always.
The facility's own certified nursing assistant job description, in place since December 2019, required staff to follow established safety precautions when performing tasks and using equipment. That document predated the lift manual by nearly a year. The expectation had been written down in two separate places.
It didn't matter.
The inspection, triggered by a complaint, was completed in November 2025. Inspectors classified the violation at a level of actual harm, meaning the failure wasn't a paperwork problem or a procedural gap on paper. Someone was hurt.
Mechanical lifts exist because transferring a resident from a bed to a wheelchair, or from a chair to a shower, carries real risk. The belts are the margin between a controlled transfer and a fall. When that margin is removed, the resident bears the consequences.
The facility had written the rule. The facility had trained staff to follow safety precautions. None of it closed the distance between what the manual required and what happened in that room.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Avantara Arrowhead from 2025-11-06 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 4, 2026 · Our methodology
AVANTARA ARROWHEAD in RAPID CITY, SD was cited for violations during a health inspection on November 6, 2025.
Federal inspectors cited the facility for causing actual harm to residents after reviewing the lift system's operating manual, dated October 2020.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.