Nursing homes in South Dakota
South Dakota has 96 Medicare-certified nursing homes, with about 4,900 people living in them on an average day. 43 of them are rated one or two stars, the lowest two grades Medicare gives. Medicare grades inspections on a curve inside each state, so those stars are a rank inside South Dakota, not a national score.
Start with your town
12 towns in South Dakota have two or more nursing homes. The number beside each one is how many.
Show the 59 towns with one nursing home
There is no town page for those, so each one goes straight to the home.
Or start with the county
Every home in South Dakota is in one of these 51, including the ones in towns too small for a page of their own.
How South Dakota is staffed
The national average is 3.86 hours. 66 of the 91 homes in South Dakota that report staffing are under 4.1 hours.
Registered nurses are the staff who notice a resident going downhill. The national average is 0.69 hours. 43 of the same 91 homes report less than 0.75 hours.
Turnover is how often the person who knows your mother's routine is replaced by someone who does not. This is the average across the 87 homes in South Dakota that report it.
Whether any of this is actually the law
Federal law does set some staffing rules: under 42 CFR 483.35 a home must have licensed nurses on duty 24 hours a day and a registered nurse for at least 8 consecutive hours a day, 7 days a week. What it does not set is a minimum number of nursing hours per resident. CMS wrote one into a 2024 rule, a federal court struck that rule down in April 2025, Public Law 119-21 barred its enforcement until 2034, and it was repealed in February 2026. So the 4.1 and 0.75 hour marks above are not law. They come from research CMS commissioned in 2001, which found that below those levels residents are more likely to be harmed. A home under them is not breaking a law. It is below the level that research tied to a higher risk of harm.
Where the benchmark comes from
Nursing hours are the number that shapes most of what happens in a home. These are the averages across South Dakota, against the level researchers found residents need.
The homes the government is watching
Show the 5 homes Medicare names as candidates
What the Special Focus list is
Medicare keeps a Special Focus Facility list, for homes with a persistent record of serious problems. South Dakota has 1 home on the list and 5 more that Medicare names as candidates. Being named a candidate is not the same as being on the list, and most candidates are never put on it. Medicare withholds the star rating for the 1 home actually on the list, so it will look like missing data anywhere else you check. It is not missing. The 5 named as candidates still carry a rating, and it is shown here. Immediate jeopardy, the term on many of the cards below, means an inspector found a resident in danger of serious harm or death right then.
Expected staffing is a published research benchmark, not a Medicare figure. We work it out from each home's own Medicare case-mix score using the CASE formula (Harrington and others, Journal of the American Geriatrics Society, 2025). It is a benchmark, not a rule, and it is a different measure from the 4.1 hour research mark above.
13 homes carry Medicare's abuse warning
Medicare puts a warning on a home when abuse was found and a resident was harmed, or when it happened twice. The warning comes off after a year.
43 homes have an abuse finding on record
Over the three inspection cycles on record, 43 homes were cited for abuse, the wrongful use of a resident's belongings or money, or involuntary seclusion. We count those three findings and nothing else. Medicare's words for the first of them: the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.
26 homes were cited for putting a resident in immediate danger
Immediate jeopardy is the most serious thing an inspector can write down. It means a resident was in danger of serious harm or death right then. Medicare's words: noncompliance that has caused or is likely to cause serious injury, harm, impairment, or death.
A star in South Dakota is not a star in New Mexico. Medicare grades inspections on a curve, inside each state, one state at a time.
Inspectors add up points for what they find, and the more points a home has, the worse it did. Medicare then sorts every home in the state by that score and hands out stars by rank. So the score it takes to earn five stars depends entirely on the company a home keeps. In South Dakota, the worst score that still earned five stars this release was 18 points.
How South Dakota's 96 homes were graded overall. 3 homes have no rating. Medicare is withholding a grade from 1 of them, because it is on the federal watch list. The other 2 are ungraded because Medicare does not yet have enough inspection history to grade them, usually because they were certified recently. Neither case is a home with nothing on record. The inspection star is the curved ingredient in that overall grade, and it sets where a home starts. So this chart is not telling you South Dakota is average. It is telling you how homes here compare to each other.
Where these numbers come from
Everything on this page comes from the Centers for Medicare & Medicaid Services, from the Provider Information, Health Deficiencies, Penalties, Ownership and State US Averages files published on data.cms.gov. This page was built from the release dated August 1, 2026. CMS dates a release from the start of the month and puts it online on the last Wednesday of that month.
What these numbers do not say
Inspection findings cover the last three survey cycles. For some homes those cycles reach back to 2018, because routine inspections were suspended during the pandemic. Fines and payment denials cover August 24, 2023 to March 25, 2026. Staffing hours are payroll-based, reported quarterly by the homes themselves, and subject to audit by CMS.
A finding on a home's record does not mean the problem is still there, and the absence of one does not mean a home is safe. Inspectors visit about once a year and see one day of it. Use this page to know what to ask about, then go and look.