49 of the 96 Medicare-certified nursing homes in South Dakota (51%) are chain-owned, and all are listed below. Nurse staff turnover runs 51%, 2.8 points higher than the 48.2% across all homes there. They average 3.59 nursing hours per resident per day, 0.2 hours below the 3.79 for every home in South Dakota. Avera Prince Of Peace in Sioux Falls grades highest at A (94 out of 100).
How chain-owned homes in South Dakota compare
This group set against every nursing home in South Dakota, from the current CMS release.
Nursing hours per resident per day
3.59
All homes in South Dakota: 3.79
Worse than the local average
Nurse staff turnover
51%
All homes in South Dakota: 48.2%
Worse than the local average
Average ElderGrade score
68.6/100
All homes in South Dakota: 71.3/100
Worse than the local average
Grade spread
A
B
C
D
5 grade A, 14 grade B, 22 grade C, 7 grade D,
The best-graded chain-owned home in South Dakota is
Avera Prince Of Peace
in Sioux Falls, SD, grade A, 94/100.
Avera Mother Joseph Manor runs a nonprofit shop with 81 certified beds, and the nurse staffing numbers look solid on paper, 4.06 hours per resident day, a bit above the national figure. But weekends tell a different story, with hours dropping roughly 17% below the home's own weekday levels, and annual turnover sits at 55.7%, well past the national 45.8%. The inspection record is where the real concern lives: 18 deficiencies, three of them serious enough to reach harm or jeopardy, plus one fine of $8,824. A 2025-12-17 inspection keeps the record current, though a 2-star inspection rating and 1-star quality measures don't inspire confidence. Strong staffing scores alone can't carry a record like this.
Good Samaritan Society Luther Manor runs 92 beds under corporate ownership, and its staffing sits just barely above the national average, 3.94 nurse hours per resident day against 3.86. That thin edge narrows on weekends, when coverage drops roughly 16% below the home's own weekday level. Turnover runs 43.5%, a touch better than the 45.8% national figure. The harder numbers are on inspections: 20 deficiencies on the current record, 5 of them at harm or jeopardy level and one abuse-related, drawing two fines totaling $21,086. The most recent inspection was March 5, 2026. Families weighing this one should ask directly what changed since that survey, particularly around the harm-level findings.
Good Samaritan Society Canton runs 56 certified beds as a nonprofit, and its 3.28 nurse staffing hours per resident day sit about 15% under the national average of 3.86. Weekends drop roughly 16% below its own weekday levels, and annual turnover of 54.2% tops the national figure of 45.8%, so even the four-out-of-five staffing star looks thinner once you see who's actually on the floor. The current record carries 8 deficiencies, 2 serious enough to involve harm or jeopardy, and $19,615 in fines across two penalties. A May 2025 inspection is recent, and there's no abuse history, but a one-out-of-five quality measure rating points to real gaps in resident care.
Avantara Groton runs 37 beds under for-profit LLC ownership, and its nurse staffing sits about 4% under the national average, with weekends roughly 12% thinner than weekdays. Turnover is where it looks better than most: 37% against a national 45.8%. The trouble is care quality, CMS scores it 1 out of 5 on quality measures, and the current record carries 22 deficiencies, one serious enough to reach harm or jeopardy level, plus a $6,168 fine. That combination of thin weekend coverage, weak measured outcomes, and a harm-level finding is what pulls the grade down, even though staffing hours and turnover aren't the main problem here.
Avantara Redfield runs on 3.03 nurse hours per resident day, about 22 percent below the national average, and weekend coverage drops roughly 19 percent below its own weekday levels. Staff turnover sits at 52.1 percent against a national 45.8 percent, so the people providing that already-thin care are cycling out faster than average. The current inspection record shows 17 deficiencies, three at harm or jeopardy level and two tied to abuse, with $23,044 in fines across three events. The most recent inspection was January 28, 2026, so the record is current rather than dated. For-profit, limited liability ownership, and the family should ask directly how weekend shifts are covered before deciding.
Avantara North runs about 3.06 nursing hours per resident per day, roughly a fifth below the national average, and weekends drop further, about 20% under its own weekday baseline, which is when families tend to visit and notice. Staff turnover sits at 35.4%, better than the 45.8% national figure, so the people who are there tend to stay. The current record carries 17 deficiencies, including 2 at the harm or jeopardy level and 3 tied to abuse, with $24,108 in fines across two penalties. The last inspection was February 2026. For-profit, LLC-owned, 68 beds.
Prairie View runs leaner than most. At 3.61 nurse hours per resident day, it sits about 6% under the national average, and weekends drop roughly 11% below its own weekday coverage, so the thinnest shifts land when families tend to visit. The bigger red flag is turnover: 73.1% of staff leaving annually against a national 45.8% means aides and nurses are constantly new, and familiarity is hard to build. Inspections turned up 11 deficiencies, including one at the harm level and one abuse-related, plus an $8,512 fine; the last survey was July 2025. For-profit LLC ownership, 42 beds, staffing and quality star ratings that don't match each other. Worth a visit on a weekend.
Spearfish Canyon Healthcare runs 105 certified beds under for-profit LLC ownership, and the staffing numbers are where your attention should go first. At 3.37 nurse hours per resident day, it sits about 13 percent under the national average, and weekends drop another 13 percent below its own weekday levels, so the coverage gap widens exactly when families tend to visit. Staff turnover of 58.8 percent against a 45.8 percent national figure means caregivers are cycling through steadily, which matters more than any single star rating. The inspection record backs that up: 21 deficiencies, including four tied to abuse and one at the harm level, with a $9,718 fine. The most recent inspection was August 2025, so the record is current, not stale.
Good Samaritan Society Sioux Falls Center runs 98 certified beds as a nonprofit, and its staffing sits at 3.58 nurse hours per resident day, about 7% under the national average of 3.86. Weekends drop roughly 12% below its own weekday coverage, which matters if your family visits or calls on Saturdays and Sundays. Turnover is 44.2%, a hair under the national 45.8%, so retention here isn't the problem. The inspection record is: 18 deficiencies, three of them at harm or jeopardy level and three tied to abuse, plus one fine of $11,261. The most recent inspection was September 5, 2025.
Sunset Manor runs a genuinely strong bedside staffing line, 5.10 nurse hours per resident day, roughly a third more than the national norm, and that's the one number here that works in families' favor. But weekends dip about 16% below the home's own weekday coverage, and the same staff is turning over at 70.4% a year against a national 45.8%, so the people delivering that care keep changing. Inspectors cited 17 deficiencies on the current record, four at harm or jeopardy level and five tied to abuse, with $40,596 in fines, and the most recent inspection closed out in late December 2025. Nonprofit ownership hasn't kept the compliance record clean.
Diamond Care Center runs on thin coverage, 2.44 nurse staffing hours per resident day against a national average of 3.86, with weekends dipping about 11% below its own weekdays. CMS gives that staffing a 1 out of 5, and the health inspection record matches: 25 deficiencies, including two at the harm level and one tied to abuse, plus $69,512 in fines. Annual turnover sits at 54.5%, well above the national 45.8%, which makes it harder to hold onto the staff who know these 36 residents. The quality measure star of 4 out of 5 shows some care processes are being tracked well, and the last inspection was September 2025. But staffing and compliance are where families usually feel the difference day to day.
Avantara Pierre runs a 65-bed for-profit home in Hughes County, and the staffing numbers are the first thing to notice: 2.81 nurse hours per resident day, roughly 27% under the national average of 3.86. Weekends thin out further, about 19% below the home's own weekday coverage. Turnover sits at 40.5%, better than the 45.8% national figure, so the people who stay seem to stay. The trouble is the record: 33 deficiencies, three of them at harm or jeopardy level, one tied to abuse, and a $22,048 fine. Inspectors were last in on April 2, 2025.
Avantara Clark City runs 35 beds in Clark, and the raw staffing number looks better than it is: 4.17 nurse hours per resident day sits about 8% above the national average, but weekend coverage drops roughly 16% below the home's own weekday level, so the hours aren't spread evenly across the week. Staff turnover of 42.4% is slightly better than the 45.8% national figure, though the CMS staffing rating still lands at 2 out of 5. Inspectors gave a 4 out of 5 health inspection rating and visited recently, in January 2026, but the record carries 7 deficiencies, including one at the harm or jeopardy level and one tied to abuse, plus a single $11,057 fine.
Good Samaritan Society Tyndall runs 68 certified beds as a nonprofit, and its last health inspection was in January 2025. The record shows 10 deficiencies, three of them serious enough to put residents in harm or jeopardy, plus three fines totaling nearly $45,000. Nurse staffing sits at 3.58 hours per resident per day, about 7% under the national average, and weekends run roughly 15% lighter than weekdays. Staff turnover is the number that would worry me most, 58.5% a year, well above the 45.8% national rate. Quality measure scores came in at 2 out of 5 stars.
Good Samaritan Society New Underwood runs 41 certified beds as a nonprofit, and its nursing hours come to 2.82 per resident day, roughly 27% under the national average of 3.86. Weekends dip about 21% below the home's own weekday staffing, so coverage thins exactly when families tend to visit. Staff turnover sits at 64.7%, well above the 45.8% national figure, which means many of the people caring for residents haven't been there long.
The inspection record shows 29 deficiencies, including two at the harm or jeopardy level and two tied to abuse, with $26,595 in fines across two penalties. The most recent inspection was in December 2025.
Avantara Huron runs on thin staffing and a rough inspection history. Nurses provide 3.40 hours per resident day, roughly 12 percent under the national average, and weekends drop about 13 percent below what the home manages on weekdays. Staff turnover sits at 54.7 percent, nearly nine points above the national figure, which means the people caring for residents keep changing. The current inspection record carries 21 deficiencies, five of them serious enough to involve harm or jeopardy, and four tied to abuse. State inspectors last visited in March 2026. This is a for-profit limited liability company operating 119 certified beds, with one fine totaling $8,338 on record.
Good Samaritan Society Canistota runs 3.23 nurse hours per resident day, about 16% under the national average of 3.86, and weekend coverage drops roughly another 11% below its own weekday levels. That staffing pattern sits alongside a 68% annual turnover rate, well above the 45.8% national figure, which means the people providing care are changing over faster than average. The current inspection record shows 17 deficiencies, two serious enough to reach harm or jeopardy level, though none involve abuse, and one fine of $9,009. The most recent inspection was in March 2026, so the record is current rather than stale.
Palisade Healthcare Center runs about 18% below the national average on nurse staffing, and weekends drop roughly another 17% below its own weekday level. The inspection record is the harder problem: 29 deficiencies, five of them at harm or jeopardy level and three tied to abuse, with four fines totaling $154,946. A 60% annual turnover rate against a 45.8% national average means the people at the bedside keep changing. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care. The quality measure score looks strong on paper, but it sits on top of a staffing and inspection record that families should ask about directly.
Good Samaritan Society De Smet runs 46 beds as a nonprofit, and its nurse staffing sits at 3.40 hours per resident day, roughly 12% under the national average. Weekends are thinner still, about a fifth below its own weekday coverage. The bigger concern is the record: 17 deficiencies, four of them at harm or jeopardy level and two tied to abuse, plus $27,989 in fines. Staff turnover hits 64.4% against a national 45.8%, meaning nearly two-thirds of the workforce leaves each year. Inspectors were last on site in May 2025. A nonprofit mission doesn't automatically produce steady hands on deck, and here the numbers say it hasn't.
Firesteel Healthcare Center runs about 10% below the national average for nurse staffing, at 3.47 hours per resident day, and weekends get thinner still, roughly 15% lighter than the home's own weekdays. The 55% annual turnover rate means more than half the nursing staff leaves within a year, well above the 45.8% national figure. The inspection record is the bigger concern: 33 deficiencies on file, eight serious enough to put residents at risk of harm, one tied to abuse, and $153,308 in fines across six penalties. Ownership is a for-profit limited liability company. The most recent inspection was April 25, 2025, so the picture is current. Ask about weekend coverage and how they've addressed the abuse-related finding.
Frequently asked questions
How many chain-owned nursing homes are there in South Dakota?
There are 49 chain-owned Medicare-certified nursing homes in South Dakota, 51% of the 96 nursing homes there.
Are chain-owned nursing homes better staffed?
In South Dakota they average 3.59 total nursing hours per resident per day, against 3.79 for all nursing homes in South Dakota, a difference of -0.2 hours. Staff turnover averages 51% against 48.2%.
Which chain-owned nursing home grades best in South Dakota?