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Five Counties Nursing Home
Nursing Home, Assisted Living, Independent Living & Skilled Nursing · Lemmon, 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.
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Five Counties Nursing Home

Nursing Home, Assisted Living, Independent Living & Skilled Nursing · Lemmon, 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.
405 6Th Ave W, Lemmon, SD 57638 View map Calculator: See prices in your area
Five Counties Nursing Home accepts Medicare, Medicaid, and private pay.
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Five Counties Nursing Home accepts Medicare, Medicaid, and private pay.

Overview of Five Counties Nursing Home

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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.

Facility Direct Line (605) 374-3871
Facility Direct Line (605) 374-3871
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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

Total nursing care / resident Info Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 9m per day
Rank #22 / 65Nurse hours — State benchmarkedThis home is ranked 22nd out of 65 homes in South Dakota for Nurse Hours. Shows adjusted nurse hours per resident per day benchmarked to the South Dakota average, with a ranking across 65 South Dakota facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.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.
vs avg

3 of 6 metrics below state avg

Standout metric Weekend RN is +19% above state avg
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. 51m per day ▲ 6% 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. 11m per day ▼ 62% 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. 1h 58m per day ▼ 25% 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 35m per day ▼ 22% 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. 3m per day ■ Avg 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. 37m per day ▲ 19% 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.
459 days
Bed community size
37-bed community
A moderately sized community that may balance personal attention with shared amenities and social activities.
Walk Score
Walk Score: 42 / 100
Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

About this community

Occupancy

Occupancy rate
80%
Rank #25 / 34Occupancy rate — State benchmarkedThis home is ranked 25th 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.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.
Similar to the South Dakota average: 79.9%
Occupied beds
29 / 37
Average occupied beds in South Dakota homes 51 beds

License Details

Facility TypeNursing Home
StatusActive
IssuanceAugust 6, 2025
CountyPerkins
License Number10641
CMS Certification Number435090

Ownership & Operating Entity

Five Counties Nursing Home is administered by Jordan Fish.

Therapy & Rehabilitation

1 service
Rehabilitation Services

Amenities & Lifestyle

Specific ProgramsAssisted Living & Independent Living

Contact Five Counties Nursing Home

Health Inspection History

Inspections since 2022
Total health inspections 6

State average N/A

Last Health inspection on May 2025

Total health citations
34 Rank #59 / 65Health citations — State benchmarkedThis home is ranked 59th 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.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
5.67 Rank #58 / 65Citations per inspection — State benchmarkedThis home is ranked 58th 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.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.

27 of 34 citations resulted from standard inspections; and 7 of 34 resulted from complaint investigations.

Breakdown of citation severity (last 4 years)
Critical health citations
0
In line with State average

State average: N/A

Serious health citations
2
In line with State average

State average: N/A

0 critical citations State average: N/A
2 serious citations State average: N/A
32 moderate citations State average: N/A
0 minor citations State average: N/A
Citations history (last 4 years)
Quality of Care moderate citation May 15, 2025
Corrected
Abuse/Neglect moderate citation Apr 09, 2025
Corrected
Pharmacy serious citation Apr 09, 2025
Corrected
Pharmacy moderate citation Apr 09, 2025
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 44
Employees 23
Contractors 21
Staff to resident ratio 1.10 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 14
Average shift 8 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 10,257

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 9 total: 4 full-time employees and 5 contractors. 9
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 11 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info 2 total: 1 full-time employee and 1 contractor. 2
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.1 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info 21 total: 12 full-time employees and 9 contractors. 21
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.2 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

41.4%

4,245 contractor hours this quarter

Certified Nursing Assistant: 9 Registered Nurse: 5 Licensed Practical Nurse: 1 Physical Therapy Assistant: 1 Respiratory Therapy Technician: 1 Other Physician: 1 Diagnostic X-ray Services Staff: 1 Occupational Therapy Aide: 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 Assistant129215,00192100%8.2
Registered Nurse4592,19692100%11
Medication Aide/Technician2029359199%9.5
Licensed Practical Nurse1124665459%8.1
Dietitian1014295560%7.8
Other Dietary Services Staff1013875964%6.6
Clinical Nurse Specialist1013694043%9.2
Mental Health Service Worker1012634145%6.4
Respiratory Therapy Technician0111216470%1.9
Physical Therapy Assistant011532628%2
Occupational Therapy Aide0112333%7.5
Other Physician01191213%0.7
Medical Director011667%0.9
Diagnostic X-ray Services Staff011355%0.6
21 Certified Nursing Assistant
% of Days 100%
9 Registered Nurse
% of Days 100%
2 Medication Aide/Technician
% of Days 99%
2 Licensed Practical Nurse
% of Days 59%
1 Dietitian
% of Days 60%
1 Other Dietary Services Staff
% of Days 64%
1 Clinical Nurse Specialist
% of Days 43%
1 Mental Health Service Worker
% of Days 45%
1 Respiratory Therapy Technician
% of Days 70%
1 Physical Therapy Assistant
% of Days 28%
1 Occupational Therapy Aide
% of Days 3%
1 Other Physician
% of Days 13%
1 Medical Director
% of Days 7%
1 Diagnostic X-ray Services Staff
% of Days 5%
View All Staffing Data

Penalties and fines

Includes penalties issued in 2025

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 $32K Rank #37 / 67Federal fines — State benchmarkedThis home is ranked 37th 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.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.
20% 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 $32K
State average $40K
Penalty History

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

1 penalty in the past 3 years

Mar 12, 2025 · $32K

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Mar 12, 2025
$32K

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. 17.1
42% worse 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. 29.9
25% worse than State average

State average: 23.9

Long-stay resident measures
Significantly below 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 32.3%
45% worse than State average

State average: 22.3%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 31.6%
38% worse 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 25.8%
In line with State average

State average: 26.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 9.9%
97% worse than State average

State average: 5.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 2.7%
39% better than State average

State average: 4.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 5.1%
46% worse than State average

State average: 3.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 8.8%
61% worse than State average

State average: 5.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 3.1%
25% better than State average

State average: 4.1%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 11.9%
51% better than State average

State average: 24.4%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 83.7%
13% worse than State average

State average: 95.7%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 95.2%
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. 2.03
34% worse 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. 2.99
62% worse than State average

State average: 1.85

Short-stay resident measures
Below average State avg: 2.6 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 66.0%
22% worse than State average

State average: 84.4%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.0%
100% better 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. 23.1%
57% 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

59% of new residents, usually for short-term rehab.

Typical stay 2 months

Private pay

32% of new residents, often for short stays.

Typical stay 2 - 3 years

Medicaid

9% of new residents, often for long-term daily care.

Typical stay 8 - 9 years

Facility Characteristics

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

Total residents 40
Medicare
4
10% of residents
Medicaid
14
35% of residents
Private pay or other
22
55% 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 09/2023.

Nonprofit
Nonprofit Corporation
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."
$3.7M
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."
-$174.5K
Nonprofit Nonprofit Corporation
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."
$3.7M Rank #53 / 63Revenue — State benchmarkedThis home is ranked 53rd 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 %.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."
-$174.5K
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.
$144.4K
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 #46 / 63Payroll — State benchmarkedThis home is ranked 46th 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.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.
$1.9M 50.9% 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 #11 / 63Payroll % — State benchmarkedThis home is ranked 11th 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.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).
$2.0M
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).
$3.9M
How we calculate these figures

This home is administered by Jordan Fish.

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 435090

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 (59% of admissions), and a typical Medicare stay runs around 2 months.

Admissions
22 total

Coverage residents most often arrive under.

Medicare 59%
Private pay 32%
Medicaid 9%
Discharges
29 total

Coverage residents most often leave under.

Medicare 34%
Private pay 31%
Medicaid 34%

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 Five Counties Nursing Home

Address 0.0 miles from city center Info Estimated distance in miles from Lemmon's city center to Five Counties Nursing Home's address, calculated via Google Maps.

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Frequently Asked Questions about Five Counties Nursing Home

Is Five Counties Nursing Home in a walkable area?

Five Counties Nursing Home has a walk score of 42. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

What is the license number of Five Counties Nursing Home?

According to SD state health department records, Five Counties Nursing Home's license number is 10641.

What is the occupancy rate at Five Counties Nursing Home?

Five Counties Nursing Home's occupancy is 80%.

Does Five Counties Nursing Home operate as a for-profit or non-profit?

Five Counties Nursing Home is registered as a non-profit in SD.

Who is the administrator of Five Counties Nursing Home?

Jordan Fish is the administrator of Five Counties Nursing Home.

How many beds does Five Counties Nursing Home have?

Five Counties Nursing Home has 37 beds.

Are there photos of Five Counties Nursing Home?

Yes — there are 4 photos of Five Counties Nursing Home in the photo gallery on this page.

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