Best Assisted Living in South Dakota

Overview of United Living Community

A central part of a downtown Brookings campus, United Living Community is an 81-bed nonprofit nursing home run by administrator Liz DeBerg and United Retirement Center. The facility handles skilled nursing, short-term rehab, respite care, and hydro-therapy. While 80% of new admissions use Medicare for short-term recovery, a smaller group of long-term Medicaid residents (18%) and private-pay clients (2%) shapes the building’s overall population, pushing the average stay to 421 days. The property sits in a highly walkable neighborhood with a Walk Score of 82, though recent financial records report a low occupancy rate of 34.1% alongside an operating deficit of $643.3 thousand on $7.8 million in revenue.

Government health logs show high staffing numbers, led by a daily nursing average of 5 hours and 55 minutes per resident that ranks third across South Dakota. This setup is heavily driven by nurse aides, who provide 3 hours and 48 minutes of direct care daily, helping to cover for below-average hours for registered nurses and LPNs. Clinical summaries reveal a sharp divide between short-term and long-term outcomes.

For temporary rehab residents, the logs show excellent performance, including zero major injuries from falls, zero antipsychotic drug initiations, and zero hospital readmissions. Conversely, tracking files show that permanent residents experienced higher rates of major fall injuries, antipsychotic usage, and daily activity decline than the state average, though the facility’s total federal fines sit low at $13,000.

Interested individuals looking over local care options can use these public tracking reports to see how the building handles different types of stays. Since the state logs verify top-tier daily care hours and flawless physical recovery scores for short-term rehab clients alongside low occupancy and some weak long-term safety numbers, the paperwork fits a building optimized for post-acute recovery.

Overview of Strand-Kjorsvig Community Rest Home

Run by administrator Samuel Van Voorst and owner Shannon Schmidt, Strand-Kjorsvig Community Rest Home handles skilled nursing, short-term rehab, and respite care within a 33-bed private facility that also serves as a VA-qualified provider. Founded in 1957, the downtown building works with a varied payer group comprising 44% private-pay, 34% Medicaid, and 22% Medicare admissions, leading to an average stay of 229 days. The property is located in an area with a Walk Score of 22, maintaining a 64.4% occupancy rate and reporting a 2024 operating profit of $64.3 thousand on $2.8 million in revenue.

Public oversight databases highlight high staffing numbers, with total nursing care averaging 5 hours and 3 minutes per resident daily to rank ninth across South Dakota. Daily records show robust numbers for both registered nurses and LPNs, including strong weekend RN continuity, though contractors make up 28.1% of overall staff hours.

Clinical tracking summaries reveal solid long-term stability, with permanent residents recording favorable rates for major fall prevention, skin integrity, and walking abilities. However, the data points to some specific hurdles, as long-stay resident weight loss and antipsychotic drug use track higher than state benchmarks, and the home has compiled $56,000 in federal fines across eight penalties over the past three years.

Prospective residents weighing regional long-term care or rehab facilities can analyze these government health records to assess daily operational trends. Since the state reports confirm top-tier nursing hours and steady physical health outcomes alongside historical compliance fines and some specific dietary tracking issues, the documentation shows a small, highly staffed environment.

Tieszen Memorial Home INC serves Turner County residents through a full continuum of care that includes skilled care, memory care, assisted living, and independent living. The nonprofit community operates as a 64-bed nursing home in Marion, South Dakota, under administrator Laura Wilson.

Tieszen’s CMS record is strong. Three inspections since 2022 have resulted in 7 citations, well below the South Dakota average of 14.8. There were no critical or serious findings, and all citations were corrected. The facility’s 4-star overall CMS rating reflects above-average performance on both Health Inspections and Staffing. Nurse hours average 4 hours and 33 minutes per resident per day, 21% above the South Dakota mean, placing the facility15th among 57 state SNFs.

Occupancy is 89.2%, notably above the state’s average of 79.9%, which shows consistent local demand. Residents stay at an average of 409 days, indicating a population that trends toward longer-term placement. Rehabilitation services and a Wellness Center support residents with post-acute and ongoing care needs alongside the memory care and assisted living programs.

Tieszen Memorial Home INC fits older adults and families seeking a nonprofit community with a broad care continuum, from independent living through skilled and memory care, in a smaller rural South Dakota setting.

Overview of Sun Dial Manor

Sun Dial Manor operates as a nonprofit skilled nursing and assisted living community in Bristol, South Dakota. The 37-bed facility serves Day County residents through short-term rehabilitation and long-term care programs and accepts Medicare, Medicaid, and private pay.

The facility holds a 2-star overall CMS rating. Health Inspection and Quality Measure scores are both roughly 20 to 27% below the South Dakota average, which accounts for the overall standing. Staffing is the counterweight: nurse staffing averages 4 hours and 21 minutes per resident per day, 39% above the state average, ranking Sun Dial Manor 18th of 57 facilities in South Dakota. CMS has recorded two federal penalties over the past three years totaling $30,000, about 24% below the state average for fined facilities, with no payment denials.

Sun Dial Manor offers physical, occupational, and speech therapy, along with 24-hour nursing care and memory care services. Outpatient therapy, transportation to medical appointments, and spiritual support round out the program. The facility’s 77% occupancy rate is in line with the statewide average of 79.9%, indicating capacity is available.

Payer mix reflects the facility’s orientation: 42% of admissions are on Medicare for short-term rehabilitation, with typical stays of 1 to 2 months.

Sun Dial Manor’s combination of above-average nurse staffing and a full therapy suite makes it well-suited to post-acute residents returning home after hospitalization or surgery. Long-term Medicaid residents make up a smaller share of admissions, and families considering that path should weigh the below-average quality measure scores, particularly fall rates, against the facility’s rural location and staffing depth.

Overview of Highmore Health

Highmore Health has served Hyde County for more than 50 years as a nursing home in Highmore, South Dakota. Caring Professionals operates the facility under administrator Kim Knox. The 39-bed community provides skilled nursing, rehabilitation, memory care, long-term care, and palliative support and accepts Medicare and Medicaid.

The facility holds a 3-star CMS overall rating. Its Health Inspection rating is above the South Dakota average, but its Quality Measures rating is below average, pulling the overall rating down.

Across three inspections since 2023, Highmore Health recorded 23 citations, averaging 7.67 per inspection, compared with a statewide mean of 3.34. One citation was classified as critical and three as serious. A $13,000 federal fine appears in the record, 67% below the South Dakota average for fined facilities, with no penalties issued in the past three years.

Occupancy runs at 90%, notably above South Dakota’s 79.9% average and ranks 15th among 54 state facilities, a signal of consistent local demand in a rural county. Physical therapist staffing is double the state average at 6 minutes per resident per day, a standout figure for a short-stay rehabilitation population. Total nurse staffing averages 3 hours and 35 minutes per resident per day, modestly below the state’s 3 hours and 46 minutes. CNA and LPN staffing are below state averages, while RN staffing is 10% above.

The facility has an active resident council to round out the care model alongside its on-site rehabilitation services.

With a payer mix weighted toward Medicare admissions and an average length of stay of 440 days, Highmore Health is structured for both short-term post-acute rehabilitation and longer-term care in a small, rural community setting.

Overview of Five Counties Nursing Home

Five Counties Nursing Home is a 37-bed skilled nursing facility in Lemmon, South Dakota, operated as a voluntary nonprofit. The facility offers short- and long-term care, rehabilitation services, memory care, and assisted living and independent living options for residents in Perkins County.

Five Counties holds a 1-star CMS overall rating, driven primarily by its Health Inspection record, which ranks the facility 53rd out of 59 South Dakota skilled nursing facilities and is 60.8% below the state average. It has accumulated $32,000 in federal fines, which is 20% below the South Dakota average among facilities that received penalties.

Staffing is the clear counterweight: total nurse staffing averages 4 hours and 9 minutes per resident per day, 4.5% above the state average, placing the facility 19th in South Dakota on that measure.

The facility accepts Medicare, Medicaid, and private pay. Occupancy rate is 87%, above the state average of 79.9%, reflecting sustained local demand in a rural market with limited alternatives.

Five Counties serves long-term and post-acute residents in the Lemmon area who require accessible skilled nursing care and accept a smaller, rural facility with a nonprofit governance model.

Estelline Nursing and Care Center serves Hamlin County residents through long-term skilled nursing and memory care services in Estelline, South Dakota. The City of Estelline operates the nonprofit 60-bed facility under administrator Jason Hanssen.

CMS rates the community 3 stars overall, with standout performance on Health Inspection and Quality Measures, both above the South Dakota average, offset by Staffing hours that run below state benchmarks across all nursing categories. Total nurse staffing averages roughly 3 hours per resident per day, about 23% below the state average on weekends, which is the figure that most directly affects residents requiring regular assistance.

The single inspection on record since 2023 resulted in one citation: a corrected nutrition finding from December 2023, placing the facility first among 59 South Dakota nursing homes with the lowest citation count. The state average over the same period is 14.8. Sanford Clinic provides on-site medical services, extending clinical access without requiring residents to travel off campus.

The facility’s occupancy rate is 87.1%, above the South Dakota average of 79.9%, indicating consistent local demand. The average length of stay is approximately 1,004 days, which reflects a population oriented toward long-term residence rather than post-acute turnover.

Estelline Nursing and Care Center suits older adults in Hamlin County seeking long-term skilled nursing care within a small, municipally operated community, particularly those for whom a strong inspection record and stable quality measures carry more weight than staffing volume.

Overview of Bethesda of Beresford

Bethesda of Beresford is a nonprofit nursing home in Beresford, South Dakota, founded in 1914 and administered by Britney Senger. The 39-bed facility offers skilled nursing, rehabilitation, therapy services, and independent living options and accepts Medicare, Medicaid, and private pay.

The facility holds a 2-star overall CMS rating, driven by a 1-star Health Inspection score, which is 21.6% below the South Dakota average. Across 5 inspections since 2023, the facility recorded 25 citations, averaging 5 per inspection, compared with a state mean of 3.34. A $16,000 civil money penalty was issued in October 2023. No critical citations appear in that window, and the single serious citation is 44% better than the state average.

The Quality Measures rating, however, is a genuine counterweight: 5 stars, 46.5% above the South Dakota average. Antipsychotic use is 15.1%, compared with a state average of 24.4%, and the UTI rate of 0.8% is 77% better than peers, both meaningful signals for long-stay residents.

The facility provides on-site rehabilitation and therapy services, with contracted physical, occupational, and speech therapy staff present most days of the week. A Resident Council meets regularly, and a state-approved Nurse Aide Training program operates on-site.

The facility’s occupancy rate is 85%, above the South Dakota average of 79.9%, with 33 of 39 beds filled. Its payer mix and average length of stay of 329 days reflect a predominantly long-term population: Medicaid covers 47% of current residents, and private-pay residents account for 50% of the census.

Bethesda of Beresford suits long-stay residents in Lincoln County seeking nonprofit, community-rooted skilled nursing care, particularly those for whom quality-of-care outcomes and low antipsychotic use carry weight alongside the inspection record.