Every Medicare-certified nursing home in South Dakota, graded on inspections, staffing, turnover
and enforcement history.
6 homes in the state sit in the federal Special Focus programme.
Sanford Chamberlain Care Center is a 44-bed nonprofit home in Brule County, and the numbers show a place where care quality and safety have been real problems. Sixteen deficiencies sit on the current record, eight of them serious enough to cause harm or put residents in jeopardy, and four tied to abuse. Federal fines total nearly $125,000 across four penalties. Staffing tells a mixed story: nurses provide 3.69 hours per resident day, which is below the national average, and weekend coverage drops about 6% below weekday levels even as turnover hits 56.9%, well above the national 45.8%. The last inspection was in August 2025, so the record is current.
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.
Rolling Hills Healthcare runs below the national average on nurse staffing, about 3.62 hours per resident day against 3.86, and weekends drop roughly 19% below its own weekday levels, which is when families tend to notice. Staff turnover sits at 65.1% against a national average of 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record is heavier still: 34 deficiencies, five at harm or jeopardy level, three tied to abuse, and four fines totaling $80,634, with the most recent inspection in February 2026. It's a for-profit limited liability company, and the pattern across these numbers is worth weighing carefully before you decide.
Avantara Milbank runs on thin staffing even before the weekends hit. At 3.23 nurse hours per resident day, it sits roughly 16% under the national average, and weekend coverage drops another 9% below its own weekday level, so the thinnest shifts are also the least supervised. The bigger warning sign is turnover: 91.5% annually, double the national rate, meaning most of the people caring for residents weren't there a year ago. Its inspection record shows 30 deficiencies, including 8 at harm or jeopardy level and 5 tied to abuse, plus three fines totaling $55,361. The most recent inspection was March 2025. For-profit corporate ownership, 55 beds, and a pattern of problems that keep recurring rather than resolving.
Avantara Norton runs 110 certified beds under for-profit limited liability ownership, and its nurse staffing sits right at the national average of 3.86 hours per resident day, essentially no cushion. Weekends drop about 10% below its own weekday coverage, so the thinnest shifts are when families tend to visit. What stands out more is the inspection record: 75 deficiencies, 19 of them at harm or jeopardy level, 5 abuse-related, plus six CMS fines totaling $153,638. Staff turnover is 55.7% against a 45.8% national average, meaning more than half the nursing staff leaves each year. CMS has placed this home in its Special Focus Facility program, a designation reserved for homes with a persistent record of serious problems.
Winner Regional Healthcare Center sits in a small South Dakota town and puts more direct nursing time into each resident than most homes in the country, about five hours a day against a national figure near four. That cushion matters, and it's the main reason inspections look solid, with the most recent visit in December 2024. The trouble is what the numbers show underneath the surface: weekend coverage drops roughly a fifth below its own weekday pace, and more than two-thirds of staff turned over last year, well above the typical rate. Eighteen deficiencies sit on the record, including three tied to abuse and one involving actual harm. Quality scores are weak despite the staffing.
Avantara Watertown is a 51-bed for-profit home, and the numbers that stand out most are on the inspection side. CMS has it in its Special Focus Facility program, a designation reserved for homes with a persistent record of serious problems, and the current file shows 31 deficiencies, including four at the harm or jeopardy level and three tied to abuse. A single CMS fine of $6,368 sits on the record, and the most recent inspection was April 29, 2026. Nurse staffing runs 3.57 hours per resident day, about 8% under the national average, and weekends drop roughly 20% below the home's own weekday levels. Staff turnover, at 44.2%, is close to the national figure, so retention isn't the outlier here. The inspection record is.
Riverview Healthcare Center is a 63-bed for-profit home in Flandreau, and the numbers behind its record deserve a hard look. Nurse staffing sits at 3.62 hours per resident per day, about 6% under the national average, and it thins out further on weekends, roughly 12% below the home's own weekday levels. Annual turnover runs 66.7% against a national 45.8%, so caregivers are cycling through constantly.
That instability shows up in the inspection record: 35 deficiencies, 14 at harm or jeopardy level, 10 abuse-related, and six fines totaling $176,867. CMS has placed it in the Special Focus Facility program, the agency's watchlist for homes with persistent serious problems. If you're considering this one, ask pointed questions about what's changed since the February 2025 inspection.
Wilmot Care Center has enough hands on deck, 4.20 nurse staffing hours per resident day, roughly 9% above the national average, but almost everything else on its record is a problem. The home has been flagged as a Special Focus Facility, the CMS watch list for homes with a pattern of serious, repeated deficiencies: 18 total on the current record, two of them at the harm or jeopardy level, plus two fines totaling $28,028. Its last inspection was in March 2025. Staff turnover sits at 60.5% against a national average of 45.8%, and weekend staffing drops about 11% below the home's own weekday level. The staffing is there; the consistency and the compliance record are not.
Medicine Wheel Village sits in Eagle Butte with 50 certified beds and a staffing picture that looks strong on paper, 4.79 nurse hours per resident day, about 24% above the national average, with turnover at 31.4% versus 45.8% nationally. Weekends run roughly 16% leaner than weekdays, so coverage isn't perfectly even. The trouble is what inspections have found: 27 deficiencies, including one at the harm or jeopardy level and three tied to abuse, plus a $22,636 fine and a place in CMS's Special Focus Facility program. Quality measure scores look good, but a recent inspection and that many citations on record are the numbers that matter most for daily safety.
Avantara Saint Cloud runs a 78-bed for-profit home in Rapid City under an LLC, and the numbers raise real questions. Nurse staffing sits at 3.12 hours per resident day, about 19% under the national average of 3.86, and weekends drop roughly another 9% below the home's own weekday coverage, so the thinnest shifts land when families often visit. Staff turnover is 57.3% against a national 45.8%, meaning more than half the nursing team turns over in a year. On the current record: 17 deficiencies, three at harm or jeopardy level, two tied to abuse, and $24,751 in fines. The most recent inspection was January 2026.
Avantara Arrowhead runs on 3.52 nursing hours per resident day, about 9% under the national average, and weekends dip roughly 7% below its own weekday staffing. That thin coverage sits alongside a 76.1% annual turnover rate, well above the 45.8% national figure, meaning the aides and nurses at the bedside are frequently new. The current inspection record shows 37 deficiencies, nine of them serious enough to cause harm or jeopardy, four tied to abuse, and five fines totaling $82,863, with the last inspection in September 2025. For-profit, LLC-owned, 68 beds. The pattern across staffing, turnover, and inspection history is what drives the low marks.
Good Samaritan Society Miller runs 50 beds in Hand County, and the numbers here deserve a close look before you decide. Nurse staffing sits just under the national average, but weekends run about 15 percent thinner than weekdays, and annual turnover of 70.8 percent means most of the people caring for residents are relatively new, against a national rate nearer 46 percent. The inspection record shows 22 deficiencies, four of them at harm or jeopardy level and two tied to abuse, with $96,127 in fines across two penalties. A recent February 2026 inspection and a 1-out-of-5 quality measure score round out a picture worth asking hard questions about.
Good Samaritan Society - Wagner runs 50 certified beds as a nonprofit corporation, and its current record shows no deficiencies at all, not at the harm or jeopardy level, not abuse-related, nothing. The last inspection was January 7, 2026, so the state's findings are recent, not a stale snapshot from two or three years back. A clean record like that usually reflects steady day-to-day operations rather than luck, since inspectors tend to flag something on most surveys. What the data here can't tell you is how the place feels to visit, staffing ratios at the moment you'd call, how the dining room runs, whether your family member's specific needs fit. Ask those questions on a tour, and ask what happens when a resident's condition changes.