South Dakota Nursing Homes: Violations, Fines and Worst Records

For serious citations per nursing home, South Dakota comes in fifth out of the 50 states plus Washington, D.C. Inspection files from CMS, the federal agency for Medicare, show 239 citations finding resident harm or immediate danger during the last three inspection cycles, across the state's 96 nursing homes. The national average is 1.54 serious citations per home, and the South Dakota rate sits above it. South Dakota homes received 144 citations for violating rules on accident hazards and supervision; 71 of these involved immediate danger or harm to a resident.

Of South Dakota's 96 nursing homes, non-profit organizations operate 60, 31 are for-profit, and five belong to the government. In the state's homes, 48.2% of nursing staff left within a year; the national figure is 45.8%. Avantara Norton is a South Dakota facility. Federal regulators also placed it into the Special Focus Facility program, meant for homes where serious inspection problems keep occurring. In November 2025, CMS fined Palisade Healthcare Center, located in Garretson, $122,476, the largest single federal fine South Dakota's nursing homes have received.

The South Dakota Department of Health posts state inspection findings on its Health Facility Survey Reports: Nursing Facility Reports page, where families can read them. Routine survey reports and complaint inspection reports appear there as PDF files for every South Dakota nursing home, organized by city and date. Federal inspection reports for each South Dakota home, known as the Form CMS-2567, or statement of deficiencies, can also be opened from the home's page on Medicare's Care Compare. Nursing Home Compare was the search tool's former name.

People with concerns about a South Dakota facility's care can call the South Dakota Department of Health, Office of Licensure and Certification at 605-773-3356, or file a complaint through its regulatory compliance review page. Housed in the South Dakota Department of Human Services, Division of Long Term Services and Supports, South Dakota's Long-Term Care Ombudsman Program is another option for families. State ombudsman staff help residents of South Dakota nursing homes, and their families, work out day-to-day problems with care.