Best Assisted Living in South Dakota

Overview of Rolling Hills Healthcare

Rolling Hills Healthcare is a nursing home in Belle Fourche, South Dakota, providing short-term rehabilitation, long-term residential care, skilled nursing services, and specialized medical support. Administered by Gerald Bosen, this 83-bed community has a Medicare certification to serve Butte County and the surrounding Black Hills region. Both Medicaid and Medicare are accepted, helping make care accessible to residents with a variety of healthcare coverage needs.

Services include rehabilitation therapy, long-term and short-term nursing care, licensed nursing support, pain management, dental care, dialysis services, and podiatry care. Notably, the availability of dialysis, dental, and podiatry services within the community in a rural western South Dakota setting helps reduce the need for residents to travel to larger regional healthcare centers for routine specialty treatment and ongoing clinical management.

Its location near Spearfish and Rapid City also makes the community an important regional care option for families in areas with fewer nearby skilled nursing choices. The surrounding neighborhood has a Walk Score of 47, offering limited walkability with some nearby destinations accessible on foot, while most errands still require transportation.

Rolling Hills Healthcare is well-suited for older adults in Belle Fourche and the broader Butte County region who require skilled nursing care, post-hospital rehabilitation, or long-term residential support. Its wide range of specialized services available on-site is beneficial for older adults managing chronic medical conditions, ongoing pain concerns, or dialysis needs.

Overview of Oakview Terrace

Oakview Terrace operates a 45-bed nursing home at 510 East 8th Street in Freeman, Hutchinson County, South Dakota. Courtney Unruh administers the facility, which is certified by the Centers for Medicare & Medicaid Services under a governmental community model supported by a subsidized facility district. The neighborhood presents limited walkability (Walk Score 26), with most activities and services requiring a vehicle.

The facility carries a 5-star overall CMS rating; 99.2% above the South Dakota average. This top rating reflects performance across three rating dimensions. Health inspection ratings stand at 5 stars (17.6% above state mean).

The staffing rating of 5 stars reflects 4 hours 47 minutes of total daily nursing per resident, placing the facility 11th among 57 South Dakota facilities and 27% above the state average of 3 hours 46 minutes. Nurse aide coverage averages 3 hours 16 minutes daily, exceeding the state mean by 25%. Quality measures score 5 stars (83.2% above state average).

Clinical performance demonstrates measurable strength across preventive care and patient outcomes.

Falls resulting in major injury occur in 2.6% of long-stay residents compared to 5.0% statewide, which is 48% better performance than average.

Pressure ulcer prevalence in high-risk residents reaches 0.0% versus a state average of 4.5%. Urinary tract infections similarly stand at 0.0% versus 3.5% statewide. Hospitalizations occur at 0.18 per 1,000 resident care days against a state benchmark of 1.51 (88% lower).

Emergency department visits total 0.51 per 1,000 resident days compared to 1.85 statewide; a 72% improvement over the average rate.

Regulatory compliance data from three recent state inspections document 11 total health citations, ranked 19th among 59 South Dakota facilities and 17% below state average. Zero critical citations were issued. Federal penalties total $21,000, roughly half the state average of $40,000. The current resident census numbers 44, distributed across private pay (50%), Medicaid (43%), and Medicare (7%).

An active Resident Council convenes regularly. On-site nurse aide training and a wellness program are available. The facility maintains involvement with community engagement programming.

Oakview Terrace provides skilled nursing with 5-star clinical and quality ratings in a small rural South Dakota setting.

Overview of Avantara Norton

Avantara Norton is a nursing home in Sioux Falls, South Dakota, offering skilled nursing and post-acute rehabilitation. As one of the larger options in the Sioux Falls market, this 110-bed community is one of the larger senior providers in the state. The community also accepts Medicare, Medicaid, and private pay, providing access to families from a wide range of financial backgrounds.

The community features a distinct balance of nursing resources and clinical oversight, with 3 hours and 32 minutes of total nursing care per resident per day, which sits 6% below the state average. Licensed Practical Nurse (LPN) coverage is a notable operational strength, averaging 44 minutes per day, which is 52% above the state average, indicating solid, hands-on daily bedside support. Conversely, daily RN hours average 35 minutes, and weekend RN coverage stands at 22 minutes per day, both falling below the state average. Additionally, both physical therapist hours and general weekend staffing closely track South Dakota state averages.

Notably, the community currently holds a 1-star overall CMS rating, placing it below state averages for health inspections and quality measures, while its staffing metrics sit approximately 30% below average.

A wide range of specialized nursing capabilities and post-surgical recovery resources is provided, including on-site infrastructure such as dedicated physical therapy equipment, full-time therapists, and standardized home assessments. The care team delivers tailored treatments across multiple fields, including cardiac care, stroke recovery, memory care, orthopedic care, oncology care, wound care, IV therapy, G-tube management, and bariatric care. This extensive clinical reach primarily serves a short-stay population, with Medicare admissions making up roughly 47% of incoming residents and averaging a short-term stay of 27 days.

The community primarily serves short-stay individuals, with an overall average length of stay of 97 days. Located in a moderately walkable Sioux Falls neighborhood, it features a Walk Score of 61. It remains a strong option for local families looking for extensive post-acute rehab and diverse, specialized clinical capabilities in a modern setting.

Providing a wide range of clinical specialties, Avantara Norton is ideal for families in Sioux Falls requiring complex medical nursing care, post-surgical recovery, or specialized rehabilitation. However, families are advised to take into consideration its newer status and CMS rating.

Overview of Avantara Mountain View

Avantara Mountain View is a nursing home in Rapid City, South Dakota, offering skilled nursing and post-acute rehabilitation. Privately operated by Mountain View SD Skilled Nursing Facility, LLC, this 95-bed community is currently operating at 81% occupancy rate, which is similar to the state average and reflects local demand.

Operating under federal CMS guidelines and South Dakota state licensure, the community features a robust multi-disciplinary care framework. The clinical support specializes in high-acuity post-surgical care, stroke and neurological recovery, cardiac rehabilitation, and orthopedic stabilization. A defining structural strength of the community is its physical therapy staffing ratio, which tracks 33% above the South Dakota state average. While average nursing hours sit slightly below state benchmarks at 3 hours and 25 minutes per resident daily, the overall care matrix successfully minimizes long-stay risks, achieving a major injury fall rate that is 66% lower than the state average and maintaining exceptionally low indicators for resident depressive symptoms.

The community consistently maintains an above-average performance track, with a 3-star overall CMS rating, where quality measures and health inspection scores outperform the state average. In its past inspection cycles, a localized cluster of moderate citations tied to routine pharmacy services and infection control protocols has been identified, which resulted in a single minor federal fine in mid-2024 that is 77% below regional averages. However, all findings were systematically resolved under approved plans of correction.

Positioned in a well-established neighborhood pocket, the community achieves a walk score of 83, ranking eighth highest among similar communities statewide, giving visiting families and ambulatory residents excellent pedestrian access to local pharmacies, retail centers, and restaurants.

Avantara Mountain View’s unique combination of high physical therapy concentration, strong short-term rehabilitation metrics, and an exceptionally walkable urban location makes it a practical option for post-hospitalization care in Rapid City and the broader Black Hills.

The South Dakota Developmental Center – Redfield is a state-operated ICF/IID community in Redfield, South Dakota, providing specialized residential care and support services for individuals with intellectual and developmental disabilities. With 240 licensed beds, the community is one of the largest publicly operated developmental disability care campuses in the state. Administered by Barb Abeln and licensed in Spink County, the community focuses on structured residential living, individualized support, and quality-of-life programming for those with complex developmental needs.

The community focuses on promoting independence, dignity, and community inclusion for individuals with intellectual and developmental disabilities, making it substantially different from traditional assisted living or nursing home care. As a state-operated Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), it is funded and regulated under a separate system from privately operated assisted living or skilled nursing communities, and CMS Nursing Home Five-Star ratings do not apply.

Staffing support, community partnerships, and employment and local business integration opportunities are designed to encourage engagement and participation within the broader community. These initiatives are in line with the person-centered philosophy commonly emphasized in developmental disability services.

The surrounding Redfield location has a Walk Score of 58, reflecting moderate walkability and access to some nearby services and destinations on foot. With its large capacity and state-supported structure, the community is equipped to serve a broad range of developmental disability support needs requiring intensive supervision and coordinated residential care.

The South Dakota Developmental Center – Redfield is best suited for individuals with intellectual and developmental disabilities who require comprehensive residential services, structured support systems, and ongoing state-supervised care. Notably, placement is generally coordinated through the South Dakota Division of Developmental Disabilities, and families or advocates interested in services are encouraged to begin the referral process through official state channels.

Lifescape is an independent nonprofit organization in Sioux Falls, South Dakota, providing specialized residential, therapeutic, educational, and rehabilitation services for children and adults with intellectual and developmental disabilities, as well as those with complex medical and rehabilitation needs. Administered by Kimberly Marso, this 96-bed community is licensed by the state of South Dakota as an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Unlike a traditional assisted living or nursing home setting, the community operates as a mission-focused disability services provider with an extensive continuum of clinical, educational, and residential support programs.

Since the community operates under ICF/IID licensure and federal Medicaid certification standards, it is regulated differently from conventional nursing homes and is not evaluated through the CMS Nursing Home Five-Star Rating System. Oversight instead follows state and federal standards specific to developmental disability care and rehabilitation services.

The scope of services available is notably broad and reflects decades of nonprofit investment in specialized disability support throughout South Dakota. Confirmed programs include a Children’s Specialty Hospital, Medically Complex Program, inpatient rehabilitation services, Lifescape Schools and Specialty School, children’s and adult residential services, Community Life and Day Services, Supported Employment, and Conflict-Free Case Management. Outpatient therapy services, autism support programs, clinical psychology, physician services, speech-language pathology, feeding and swallowing therapy, orthotics and prosthetics, wheelchair and mobility solutions, assistive technology, and a Center for the Arts are also offered. This level of integrated programming is uncommon and positions the community as one of the most comprehensive disability care providers in the region.

Lifescape’s residential and therapeutic environment is best suited for children and adults who require ongoing developmental disability support, structured residential care, rehabilitation therapies, or medically specialized services. It is also one of the most comprehensive disability care organizations in South Dakota for families, caregivers, and advocates supporting individuals with intellectual, developmental, or medically complex disabilities in the Sioux Falls area.

Overview of Avantara Milbank

Avantara Milbank is a nursing home in Milbank, South Dakota, focused primarily on short-term recovery and post-acute care services for older adults. Privately owned and operated, this 45-bed community is currently operating at a 68% occupancy rate, which is lower than the state average and suggests availability for immediate placements. Furthermore, it serves a resident population largely composed of Medicare and private-pay individuals, with an average length of stay of approximately 127 days, which reflects its rehabilitation-centered approach rather than long-term custodial care.

The community underwent six inspections and received 18 citations over the past seven years, a figure above the South Dakota average. Between late 2023 and the end of 2024, three federal penalties were issued related to regulatory deficiencies. Six citations were also categorized as serious in severity, substantially higher than the statewide average, highlighting areas of compliance concern.

Additionally, the most recent inspection, completed in March 2025, identified deficiencies involving quality of care, resident rights, and nutrition services, all of which were subsequently corrected. Notably, the community has not recorded any immediate jeopardy findings or critical-level citations.

Staffing levels align with the community’s focus on rehabilitation and transitional care, with an average of 3 hours and 23 minutes of nursing care daily, which is slightly below the South Dakota average. Certified nursing assistants also make up the largest share of direct care staffing, while contract staff account for roughly 20% of total staffing hours.

Clinical programming focuses heavily on post-acute recovery and includes specialized support for post-surgical rehabilitation, stroke recovery, cardiac care, orthopedic rehabilitation, and pulmonary care. These services are designed for residents recovering from hospitalization or complex medical events who require time-limited skilled nursing oversight and therapy before returning home or transitioning to a lower level of care.

Focusing on post-acute therapy and specialized rehabilitation services, Avantara Milbank is best suited for older adults in the Milbank area seeking short-term rehabilitation and clinically focused recovery support within a moderately sized community.

Overview of Menno-Olivet Care Center

Menno-Olivet Care Center is a church-operated nonprofit nursing home in Menno, South Dakota, that offers long-term care, assisted living, short-term rehabilitation, respite services, hospice care, and outpatient therapy. The 41-bed community is owned by Lacee Feltman, administered by Aisha Abbink, and accepts Medicaid. Additionally, its occupancy rate is 58.3%, which falls below the state average and suggests availability.

The community maintains a 5-star overall CMS rating and performs substantially above South Dakota averages in both health inspections and staffing measures. Staffing represents the community’s strongest performance area, with total nursing hours reaching nearly double the statewide average. Weekend nursing coverage and registered nurse availability also exceed state benchmarks by significant margins, while licensed practical nurse and nurse aide hours remain above average as well. Quality measure scores, however, fall somewhat below statewide averages, making it worthwhile for families to review specific outcome metrics alongside the community’s staffing strengths.

Amenities and services include private and semi-private rooms, a spa-style whirlpool room, outpatient therapy services, and coordination for Meals on Wheels support. Respite care, hospice, and rehabilitation services are also available to broaden the range of care available within the community.

Menno-Olivet Care Center is especially well-suited for older adults and families in Hutchinson County and rural south-central South Dakota who value exceptionally high staffing levels, faith-based care, and a smaller community-oriented environment focused on personalized support and direct caregiving attention.

Overview of Trail Ridge Retirement Community

Trail Ridge Retirement Community is a senior living community in Sioux Falls, South Dakota, offering independent living, assisted living, and memory care. This 72-bed community is licensed in Lincoln County in 2025, making it one of the newer senior care providers in the area.

Rehabilitation services, licensed nurses, and CNAs on staff, home care services, and wellness programs are provided, along with various living options, including independent living, assisted living, and memory care, under one roof. Additionally, Home care services extend the community’s reach beyond the building itself, offering flexibility for older adults who may not yet be ready for full residential placement.

Its location on Ralph Rogers Road, in southwest Sioux Falls, carries a Walk Score of 13, reflecting a car-dependent neighborhood where most errands and services will require transportation. Families visiting from the Sioux Falls metro area or surrounding Lincoln County neighborhoods are encouraged to plan travel accordingly.

Trail Ridge Retirement Community is ideal for older adults seeking a mid-sized community that spans independent living through memory care in the Sioux Falls and Lincoln County area, particularly those who value licensed clinical staff on-site and home care services as a transitional option.

Overview of Stoneybrook Suites Assisted Living

Brand new to the Sioux Falls assisted living market, StoneyBrook Suites opened in early 2025 as a 54-bed private-pay community for residents age 65 and older. Administered by Jody Elton, the facility sits 3.6 miles from downtown on E Pampas Place, somewhat accessible by foot (Walk Score 47) but better served by car, with hospital proximity at 0.93 miles.

StoneyBrook declines Medicare and Medicaid, positioning itself as an independent-pay model. This operational approach signals orientation toward residents with personal resources or long-term care insurance rather than public-program dependent populations.

Care spans assisted living, nursing and wellness support, restorative therapy, and dietary services managed in-house. The differentiator lies in on-site clinical resources: primary care physicians and physical therapists work from the facility, eliminating referral delays and transportation barriers for routine geriatric medical needs. Short-term rehabilitation rounds out the service mix.

Studio, one-bedroom, and two-bedroom suites all feature kitchenettes and walk-in showers. The facility, recently remodeled, includes a theater, coffee shop, full-service salon, courtyard and patio areas, and landscaped park grounds. Wellness programming and religious services complete the lifestyle model.

Emergency systems meet regulatory requirements; detailed compliance history is not yet publicly available for a facility in its operational infancy. The license term runs through June 2026.

StoneyBrook fits private-pay residents 65 and older seeking assisted living with integrated primary care and therapy services in a newly built Sioux Falls environment.