South Dakota Best Medicaid Nursing Homes 2026

Nurse hours

4.44 /day

Staff turnover

23%

Serious cites

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Oakview Terrace runs on 4.44 nurse hours per resident per day, roughly 15% above the national average, and its staff turnover sits at 23.4%, about half the national rate of 45.8%. That kind of retention matters more than any single inspection score, because consistent caregivers notice changes in residents sooner. The trade-off shows up in the inspection history: 11 deficiencies on record, including two at the harm or jeopardy level and one tied to abuse, plus a $10,839 fine. Weekend staffing also dips about 9% below its own weekday level, so coverage isn't perfectly even across the week. The most recent state visit was June 26, 2025, so the picture is current. Strong staffing and quality numbers, with real inspection problems worth asking about directly.

Nurse hours

4.53 /day

Staff turnover

31%

Serious cites

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Bethesda Home runs on 4.53 nursing hours per resident day, roughly 17 percent above the national average, and its staff tends to stay, turnover of 30.6 percent against a national figure near 46 percent. Weekends dip about 19 percent below its own weekday staffing, so ask how that gap gets covered. The eight deficiencies on record include nothing at the harm level and nothing abuse-related, and the most recent inspection was April 2026. Church-affiliated nonprofit ownership with 50 certified beds. The weak spot is thin weekend coverage; the strong spots are retention and a clean harm record.

Nurse hours

5.74 /day

Staff turnover

25%

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Avera Prince Of Peace runs on church-affiliated nonprofit ownership, and the staffing numbers show it: 5.74 nurse hours per resident day, roughly half again the national average, with turnover at 25% against a national 45.8%. Weekend coverage dips about 7% below weekday levels, but that's a modest drop for a 126-bed home. The caution sits in the inspection record. Seventeen deficiencies, three tied to abuse and one serious enough to reach harm or jeopardy, plus an $8,278 fine, pulled the health inspection rating down to 2 of 5 despite strong marks on quality measures and staffing. The most recent survey closed in August 2025, so that record is current.

Nurse hours

4.40 /day

Staff turnover

43%

Serious cites

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Avera Brady in Mitchell runs a tight ship on the numbers that matter most. Nurse staffing sits at 4.40 hours per resident day, roughly 14% above the national average, and turnover of 43.4% is slightly better than the typical 45.8%, both signs of a stable, adequately staffed floor. The catch: weekend coverage dips about 12% below its own weekday level, so care may thin out on Saturdays and Sundays. Eight deficiencies on record, none at harm or jeopardy level and none abuse-related, with the last inspection in April 2026. For a nonprofit home of 84 beds, that's a clean recent record.

Nurse hours

4.20 /day

Staff turnover

34%

Serious cites

0

Clarkson Health Care runs on 4.20 nurse hours per resident day, roughly 9% above the national average, and its staff turnover of 34% sits well below the 45.8% norm, two signs of a stable, adequately covered floor. The catch is weekends, when staffing drops about 18% below its own weekday level, so care may look different on a Saturday than a Tuesday. Six deficiencies on record include one at the harm level, though none involve abuse, and the most recent inspection came in July 2025. As a nonprofit with 49 beds, it has the size and structure to keep an eye on those weekend gaps.

Nurse hours

4.62 /day

Staff turnover

47%

Serious cites

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Avera Maryhouse Long Term Care in Pierre runs on unusually deep nursing coverage, 4.62 hours per resident day, roughly a fifth more than the national figure, and its most recent inspection in September 2025 backs that up with a clean record on harm-level deficiencies. Nine total deficiencies with none causing injury or jeopardy is a good place to be, though one abuse-related citation is worth asking about directly. Staff turnover sits at 46.6%, essentially level with the national rate, so continuity of caregivers isn't unusually bad here, but it isn't a strength either. Weekend staffing drops about 16% below weekday levels, which is common but still means fewer hands on Saturdays and Sundays.

Nurse hours

4.10 /day

Staff turnover

31%

Serious cites

0

Avera Sister James Care Center runs on 4.10 nurse hours per resident per day, roughly 6% above the national average, and its weekend coverage dips about 10% below its own weekday level, worth asking about if you're planning visits or worrying about Saturday-night care. Staff turnover sits at 31.3%, well under the national 45.8%, which suggests people stay. Nine deficiencies on the current record, one serious enough to reach harm or jeopardy level, none abuse-related, and the last inspection was May 2026, so the record is recent rather than stale. Nonprofit ownership under Avera. The numbers point to a home that's generally steady on staffing and quality, with one inspection finding worth reading closely.

Nurse hours

5.10 /day

Staff turnover

32%

Serious cites

0

Dow Rummel Village runs a nonprofit home with 50 certified beds, and its staffing is the standout: 5.10 nurse hours per resident day, about a third more than the national average, with turnover at 31.5% against 45.8% nationally. Weekends dip roughly 17% below weekday coverage, which is common but worth asking about. The inspection record is where it gets harder, a 2-out-of-5 health inspection rating, nine deficiencies with three at harm or jeopardy level, and four fines totaling $90,053, most recently inspected January 8, 2026. Good staffing and strong quality measures don't erase a rough survey history, so ask what changed since that inspection.

Nurse hours

5.48 /day

Staff turnover

48%

Serious cites

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White River Health Care Center runs on unusually heavy staffing, 5.48 nurse hours per resident day, roughly 42% above the national average, and it shows in the federal stars, with 5s for staffing and health inspections and a 4 for quality measures. The catch is consistency: weekend coverage drops about 15% below the home's own weekday level, and turnover sits at 47.8%, slightly worse than the 45.8% national figure. Its three deficiencies include one at the harm level and one tied to abuse, with a single $6,168 fine. The most recent inspection was March 27, 2025. Nonprofit ownership and strong weekday staffing are real strengths; the harm-level finding is the piece worth asking about directly.

Nurse hours

8.62 /day

Staff turnover

37%

Serious cites

0

Nurse staffing at the Yankton state-run home runs 8.62 hours per resident day, more than double the national figure of 3.86, and weekends dip only about 13% below its own weekday level, a smaller drop than many homes see. Annual turnover sits at 37.4%, better than the 45.8% national average. Inspectors visited recently, in June 2025, and found five deficiencies, none causing harm or jeopardy, though one is abuse-related. The 2/5 quality measure rating is the number to ask about on your next call.

Nurse hours

4.40 /day

Staff turnover

36%

Serious cites

0

Menno-Olivet runs on a nonprofit model with 41 certified beds, and the staffing numbers stand out: 4.40 nurse hours per resident day, roughly 14% above the national average, with a 5/5 staffing rating to match. Weekend coverage dips about 9% below its own weekday level, which is worth asking about if your family visits on Saturdays or Sundays. Staff turnover sits at 35.7%, better than the 45.8% national figure, so the people caring for residents tend to stick around. The inspection record is strong, a 5/5 rating with six deficiencies total, though one reached harm or jeopardy level. The weaker spot is quality measures at 2/5, so ask what specifically drives that score.

Nurse hours

3.80 /day

Staff turnover

35%

Serious cites

0

Bowdle Nursing Home is city-owned, and that shows in its stability. Staff turnover runs 34.8%, well under the 45.8% national average, a big deal in a 27-bed home, where losing even a few aides can unsettle care. The nursing hours come in just slightly under the national average, and weekends dip about 9% below weekdays, so ask how coverage holds up on Saturdays and Sundays. Its last inspection was July 2025, and the five deficiencies on record include none tied to harm or abuse. Four stars on inspections and staffing, three on quality measures, solid footing, with room to ask questions.

Nurse hours

4.60 /day

Staff turnover

54%

Serious cites

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The Neighborhoods At Brookview is city/county-owned, and it shows in the staffing: 4.60 nurse hours per resident day, roughly 19% above the national average. Inspections back that up, a 5/5 health inspection rating, only 8 deficiencies on record, none at harm or jeopardy level and none abuse-related, with the most recent survey in November 2025. The tradeoffs are real, though. Staff turnover sits at 53.6% against a national 45.8%, and weekend coverage runs about 14% thinner than weekdays, so the hands-on care you see on a Tuesday may not match what a Saturday brings. Quality measures land mid-pack at 3/5.

Nurse hours

3.23 /day

Staff turnover

33%

Serious cites

0

Avantara Lake Norden runs lean on nursing hours, 3.23 per resident day against a national average of 3.86, and weekends get thinner still, about a tenth below its own weekday coverage. What keeps it from being a bigger concern is consistency: turnover sits at 32.6%, well under the 45.8% national figure, so the aides and nurses you'd meet have mostly stayed put, and a 2025 inspection found no abuse issues. Six deficiencies are on record, two serious enough to involve harm. For-profit ownership under an LLC. The staffing number is really the thing to ask about when you tour, whether it reflects how the place actually runs on a Saturday night.

Nurse hours

3.85 /day

Staff turnover

33%

Serious cites

0

Wakonda Heritage Manor runs on staffing that lands right at the national average, 3.85 nurse hours per resident day against 3.86 nationwide, and weekend coverage dips about 19% below what the home provides on weekdays, so families should ask who's actually on the floor on Saturdays and Sundays. Turnover sits at 33.3%, well under the 45.8% national figure, which matters for residents who benefit from seeing the same faces. The inspection record is decent but not clean: eight deficiencies, including one at the harm level and one tied to abuse, plus a $12,675 fine. The most recent inspection was in May 2026.