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Estelline Nursing and Care Center
Nursing Home & Assisted Living · Estelline, SD
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Estelline Nursing and Care Center, Nursing Home in Estelline, SD — Signage welcoming visitors to Estelline Nursing and Care Center

Estelline Nursing and Care Center

Nursing Home & Assisted Living · Estelline, SD
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
205 Fjerestad Ave E, Estelline, SD 57234 View map Calculator: See prices in your area
Estelline Nursing and Care Center accepts Medicare, Medicaid, and private pay.
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Estelline Nursing and Care Center accepts Medicare, Medicaid, and private pay.

Overview of Estelline Nursing and Care Center

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.

Facility Direct Line (605) 873-2278
Facility Direct Line (605) 873-2278

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Health Inspection Info Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Staffing Info Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Quality Measures Info Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.

Staffing hours breakdown

Info Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day — compared to state averages

Staff typeHours / Day / Residentvs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 46m per day ▼ 5% State avg: 48m per day · National avg: 41m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 19m per day ▼ 33% State avg: 29m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 2h 3m per day ▼ 22% State avg: 2h 37m per day · National avg: 2h 20m per day
Weekend Total Nursing Info Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours. 2h 33m per day ▼ 23% State avg: 3h 19m per day · National avg: 3h 26m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation. 1m per day ▼ 77% State avg: 3m per day · National avg: 4m per day
Weekend RN Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent. 27m per day ▼ 12% State avg: 31m per day · National avg: 28m per day

Capacity and availability

Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
1,004 days
Bed community size
60-bed community
A moderately sized community that may balance personal attention with shared amenities and social activities.
Years in operation
1 year in operation
A newer community that may feature more recent facilities and programs.
Walk Score
Walk Score: 22 / 100
Car-dependent. Most errands require a car, with limited nearby walkable options.

About this community

Occupancy

Occupancy rate
90%
Rank #11 / 34Occupancy rate — State benchmarkedThis home is ranked 11th out of 34 homes in South Dakota for Occupancy. Shows this facility's occupancy rate versus the South Dakota average, with its Statewide rank out of 34. Higher occupancy signals strong local demand and financial stability.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Higher than the South Dakota average: 79.9%
Occupied beds
54 / 60
Average occupied beds in South Dakota homes 51 beds

License Details

Facility TypeNursing Home
StatusActive
IssuanceJuly 1, 2025
CountyHamlin
License Number10617
CMS Certification Number435099

Ownership & Operating Entity

Estelline Nursing and Care Center is administered by Jason Hanssen.

Amenities & Lifestyle

Specific ProgramsSanford Clinic

Contact Estelline Nursing and Care Center

Health Inspection History

Inspections since 2023
Total health inspections 1

State average N/A

Last Health inspection on Dec 2023

Total health citations
1 Rank #1 / 65Health citations — State benchmarkedThis home is ranked 1st out of 65 homes in South Dakota for Health Citations. Shows this facility's total health deficiency citations benchmarked to the South Dakota State average, with a ranking across all 65 SD facilities. Lower citation counts earn a better rank.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Citations per inspection
1 Rank #1 / 65Citations per inspection — State benchmarkedThis home is ranked 1st out of 65 homes in South Dakota for Citations Per Inspection. Shows average deficiency citations per CMS inspection for this facility versus the South Dakota mean across 65 facilities with citation data. Lower is better.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

All 1 citation resulted from standard inspections.

Breakdown of citation severity (last 3 years)
Critical health citations
1
In line with State average

State average: N/A

Serious health citations
0
In line with State average

State average: N/A

1 critical citation State average: N/A
0 serious citations State average: N/A
0 moderate citations State average: N/A
0 minor citations State average: N/A
Citations history (last 3 years)
Nutrition critical citation Dec 14, 2023
Corrected

Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 73
Employees 66
Contractors 7
Staff to resident ratio 1.35 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 29
Average shift 7.1 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 18,953

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info All 9 RN Staff are full-time employees. No contractors work on this role. 9
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.4 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 5 LPN Staff are full-time employees. No contractors work on this role. 5
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.5 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 38 CNA Staff are full-time employees. No contractors work on this role. 38
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

1.3%

249 contractor hours this quarter

Qualified Social Worker: 1 Physical Therapy Aide: 1 Respiratory Therapy Technician: 1 Physician Assistant: 1 Occupational Therapy Aide: 1 Occupational Therapy Assistant: 1 Medical Director: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant3803810,19392100%7
Registered Nurse9092,88492100%7.4
Licensed Practical Nurse5051,6108795%7.5
Other Dietary Services Staff3031,18892100%7.6
Clinical Nurse Specialist2029106368%8.8
Dietitian1014806672%7.3
Speech Language Pathologist1014786571%7.3
Mental Health Service Worker1014665964%7.9
Administrator1014485661%8
Physician Assistant011581011%5.8
Respiratory Therapy Technician213583033%1.9
Physical Therapy Aide011542830%1.9
Occupational Therapy Aide011451718%2.6
Medical Director0112533%8.3
Physical Therapy Assistant202242123%1
Occupational Therapy Assistant0111822%9.1
Qualified Social Worker112141213%1.2
38 Certified Nursing Assistant
% of Days 100%
9 Registered Nurse
% of Days 100%
5 Licensed Practical Nurse
% of Days 95%
3 Other Dietary Services Staff
% of Days 100%
2 Clinical Nurse Specialist
% of Days 68%
1 Dietitian
% of Days 72%
1 Speech Language Pathologist
% of Days 71%
1 Mental Health Service Worker
% of Days 64%
1 Administrator
% of Days 61%
1 Physician Assistant
% of Days 11%
3 Respiratory Therapy Technician
% of Days 33%
1 Physical Therapy Aide
% of Days 30%
1 Occupational Therapy Aide
% of Days 18%
1 Medical Director
% of Days 3%
2 Physical Therapy Assistant
% of Days 23%
1 Occupational Therapy Assistant
% of Days 2%
2 Qualified Social Worker
% of Days 13%
View All Staffing Data

Penalties and fines

Includes penalties issued in 2023

Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database (Data as of Jan 2026)

Total fines amount $17K Rank #34 / 67Federal fines — State benchmarkedThis home is ranked 34th out of 67 homes in South Dakota for Federal Fines. Shows this facility's cumulative CMS federal fine dollars versus the South Dakota average among facilities with fines, and where it ranks among 67 facilities in the pool. Lower total dollars mean a better rank.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
58% lower than State average

State average: $40K

Number of fines 1
51% fewer fines than State average

State average: 2.0

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
In line with State average

State average: 0.0

Fines amount comparison
Fines amount comparison
This facility $17K
State average $40K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Dec 14, 2023 · $17K

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Dec 14, 2023
$17K

Last updated: Jan 2026

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 7.0
42% better than State average

State average: 12.0

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 14.2
41% better than State average

State average: 23.9

Long-stay resident measures
Significantly above average State avg: 2.6 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 11.9%
47% better than State average

State average: 22.3%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 14.5%
36% better than State average

State average: 22.8%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 16.2%
39% better than State average

State average: 26.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 5.2%
In line with State average

State average: 5.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 0.7%
85% better than State average

State average: 4.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 1.9%
45% better than State average

State average: 3.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 2.6%
52% better than State average

State average: 5.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.0%
100% better than State average

State average: 4.1%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 22.8%
7% better than State average

State average: 24.4%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
5% better than State average

State average: 95.7%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
In line with State average

State average: 96.9%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 0.94
38% better than State average

State average: 1.51

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 1.04
44% better than State average

State average: 1.85

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
18% better than State average

State average: 84.4%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 3.2%
84% worse than State average

State average: 1.8%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than State average

State average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 28.0%
48% worse than State average

State average: 53.7%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

Breakdown by payment type

Medicare

79% of new residents, usually for short-term rehab.

Typical stay 20 days

Private pay

15% of new residents, often for short stays.

Typical stay 3 - 4 years

Medicaid

7% of new residents, often for long-term daily care.

Typical stay 4 - 5 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 54
Medicare
2
3.7% of residents
Medicaid
18
33.3% of residents
Private pay or other
34
63% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Government
City
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.8M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$337.0K
Government City
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.8M Rank #51 / 63Revenue — State benchmarkedThis home is ranked 51st out of 63 homes in South Dakota for Revenue. Shows this facility's annual revenue compared to the South Dakota average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$337.0K
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$155.4K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #34 / 63Payroll — State benchmarkedThis home is ranked 34th out of 63 homes in South Dakota for Payroll. Shows total annual staff payroll benchmarked to the South Dakota average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$3.5M 73.2% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #7 / 63Payroll % — State benchmarkedThis home is ranked 7th out of 63 homes in South Dakota for Payroll %. Shows payroll as a percentage of revenue versus the South Dakota average. Well-run South Dakota facilities typically land around 64–73% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in South Dakota that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$958.8K
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$4.5M
How we calculate these figures

This home is administered by Jason Hanssen.

This home is owned by City Of Estelline

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 435099

Show certification details

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (79% of admissions), and a typical Medicare stay runs around 20 days.

Admissions
61 total

Coverage residents most often arrive under.

Medicare 79%
Private pay 15%
Medicaid 7%
Discharges
19 total

Coverage residents most often leave under.

Medicare 68%
Private pay 26%
Medicaid 5%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

Places of interest near Estelline Nursing and Care Center

Address 0.0 miles from city center Info Estimated distance in miles from Estelline's city center to Estelline Nursing and Care Center's address, calculated via Google Maps.

Calculate Travel Distance to Estelline Nursing and Care Center

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Nursing Home Explorer

Frequently Asked Questions about Estelline Nursing and Care Center

What neighborhood is Estelline Nursing and Care Center in?

Estelline Nursing and Care Center is in the Estelline Township neighborhood of Estelline.

Is Estelline Nursing and Care Center in a walkable area?

Estelline Nursing and Care Center has a walk score of 22. Car-dependent. Most errands require a car, with limited nearby walkable options.

What is the license number of Estelline Nursing and Care Center?

According to SD state health department records, Estelline Nursing and Care Center's license number is 10617.

What is the occupancy rate at Estelline Nursing and Care Center?

Estelline Nursing and Care Center's occupancy is 90%.

Is Estelline Nursing and Care Center a government-operated facility?

Estelline Nursing and Care Center is a government-operated nursing facility in SD.

Who is the administrator of Estelline Nursing and Care Center?

Jason Hanssen is the administrator of Estelline Nursing and Care Center.

How many beds does Estelline Nursing and Care Center have?

Estelline Nursing and Care Center has 60 beds.

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