Five Counties Nursing Home

Nursing Home, Assisted Living, Independent Living & Skilled Nursing · Lemmon, SD

CMS overall rating

405 6Th Ave W, Lemmon, SD 57638 View map

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Five Counties Nursing Home accepts Medicare, Medicaid, and private pay.

Calculator: See prices in your area

Five Counties Nursing Home accepts Medicare, Medicaid, and private pay.

Overview of Five Counties Nursing Home

Located in Lemmon, South Dakota, Five Counties Nursing Home is a skilled nursing facility serving residents in Perkins County. Besides, it offers skilled nursing, short-term and long-term care, rehabilitation services, memory care, assisted living, and independent living. Residents can receive care here as their needs change. Jordan Fish serves as administrator.

The 37-bed community has an occupancy rate of about 80%. Residents stay an average of about 459 days, which points to more long-term nursing care than short rehabilitation stays.

Total nurse staffing averages 4 hours and 9 minutes per resident daily. Registered nurses provide roughly 51 minutes of that daily total. Residents receive hands-on aide support and clinical oversight throughout the day.

Medicare, Medicaid, and private pay are accepted, giving families several ways to cover short-term rehabilitation or ongoing nursing care. Lemmon is a small rural community, and Five Counties has a Walk Score of 42. A few nearby services are within walking distance, but most errands require driving. Families planning to stay longer-term should ask how staff support residents throughout extended care.

Facility Direct Line (605) 374-3871

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to South Dakota state averages

Total nursing care / resident

4h 9m per day

This facility South Dakota avg (4h 20m per day)

vs South Dakota avg

-4%

3 of 6 metrics below state avg

Standout metric Weekend RN is +19% above state avg

Staff type	Hours / Day / Resident	vs state avg
Registered Nurse (RN) 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 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 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 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 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 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

459 days

37-bed community

A moderately sized community that may balance personal attention with shared amenities and social activities.

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%

Similar to the South Dakota average: 79.9%

Occupied beds

29 / 37

Average occupied beds in South Dakota homes 51 beds

Facility TypeNursing Home

StatusActive

IssuanceAugust 6, 2025

CountyPerkins

License Number10641

CMS Certification Number435090

Five Counties Nursing Home is administered by Jordan Fish.

Rehabilitation Services

Pets not allowed

Inspections since 2022

Total health inspections 6

State average 4.5

Last Health inspection on May 2025

Total health citations

State average 14.8

Citations per inspection

5.67

State average 3.34

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

100% better than State average

State average: 0.3

Serious health citations

11% worse than State average

State average: 1.8

0 critical citations State average: 0.3

2 serious citations State average: 1.8

32 moderate citations State average: 12.6

0 minor citations State average: 0

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

Total staff 44

Employees 23

Contractors 21

Staff to resident ratio 1.10 : 1

43% fewer staff per resident than South Dakota average

Avg staff/day 14

Average shift 8 hours

0% compared with South Dakota average

Total staff hours (quarter) 10,257

Nursing staff breakdown

11 hours

8.1 hours

8.2 hours

Contractor staffing

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


Certified Nursing Assistant	12	9	21	5,001	92	100%	8.2
Registered Nurse	4	5	9	2,196	92	100%	11
Medication Aide/Technician	2	0	2	935	91	99%	9.5
Licensed Practical Nurse	1	1	2	466	54	59%	8.1
Dietitian	1	0	1	429	55	60%	7.8
Other Dietary Services Staff	1	0	1	387	59	64%	6.6
Clinical Nurse Specialist	1	0	1	369	40	43%	9.2
Mental Health Service Worker	1	0	1	263	41	45%	6.4
Respiratory Therapy Technician	0	1	1	121	64	70%	1.9
Physical Therapy Assistant	0	1	1	53	26	28%	2
Occupational Therapy Aide	0	1	1	23	3	3%	7.5
Other Physician	0	1	1	9	12	13%	0.7
Medical Director	0	1	1	6	6	7%	0.9
Diagnostic X-ray Services Staff	0	1	1	3	5	5%	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

Total fines amount $32K

20% lower than South Dakota average

South Dakota average: $40K

Number of fines 1

51% fewer fines than South Dakota average

South Dakota average: 2.0

Payment Denials 0

In line with South Dakota average

South Dakota average: 0.0

Fines amount comparison

This facility $32K

South Dakota 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 Mar 12, 2025

$32K

Last updated: Jan 2026

High-risk clinical events score 17.1

42% worse than South Dakota average

South Dakota average: 12.0

Functional decline score 29.9

25% worse than South Dakota average

South Dakota average: 23.9

Long-stay resident measures

Significantly below average South Dakota avg: 2.6

Need for Help with Daily Activities Increased 32.3%

45% worse than South Dakota average

South Dakota average: 22.3%

Walking Ability Worsened 31.6%

38% worse than South Dakota average

South Dakota average: 22.8%

Low Risk Residents with Bowel/Bladder Incontinence 25.8%

In line with South Dakota average

South Dakota average: 26.7%

Falls with Major Injury 9.9%

97% worse than South Dakota average

South Dakota average: 5.0%

High Risk Residents with Pressure Ulcers 2.7%

39% better than South Dakota average

South Dakota average: 4.5%

Urinary Tract Infection 5.1%

46% worse than South Dakota average

South Dakota average: 3.5%

Lost Too Much Weight 8.8%

61% worse than South Dakota average

South Dakota average: 5.5%

Depressive Symptoms 3.1%

25% better than South Dakota average

South Dakota average: 4.1%

Antipsychotic Use 11.9%

51% better than South Dakota average

South Dakota average: 24.4%

Pneumococcal Vaccine 83.7%

13% worse than South Dakota average

South Dakota average: 95.7%

Influenza Vaccine 95.2%

In line with South Dakota average

South Dakota average: 96.9%

Hospitalizations per 1,000 days 2.03

34% worse than South Dakota average

South Dakota average: 1.51

ED visits per 1,000 days 2.99

62% worse than South Dakota average

South Dakota average: 1.85

Short-stay resident measures

Below average South Dakota avg: 2.6

Pneumococcal Vaccine 66.0%

22% worse than South Dakota average

South Dakota average: 84.4%

Antipsychotic medication increase 0.0%

100% better than South Dakota average

South Dakota average: 1.8%

Falls with major injury 0.0%

100% better than South Dakota average

South Dakota average: 0.8%

Ability to care for self at discharge 23.1%

57% worse than South Dakota average

South Dakota average: 53.7%

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

Total residents 40

Medicare

10% of residents

Medicaid

35% of residents

Private pay or other

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.

Financial Trends

Historical financial and operational data for Five Counties Nursing Home from 2019–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 09/2023.

Occupancy Rate 86.9% ↑ 0.6pp vs 2022

Net Patient Income -$174.5K ↓ ~$179.6K vs 2022

Payroll Costs $1.9M ↓ ~$272.0K vs 2022

Operating Margin -4.7% ↓ 4.9pp vs 2022

Metric	2019	2020	2021	2022	2023
Occupancy %	93.6%	85.6%	88.5%	86.3%	86.9%
Beds	43	42	40	42	42
Net Income	$131,600	$561,634	$1,318,023	$460,224	-$30,172
Gross Revenue	$3,172,679	$3,687,848	$3,678,841	$3,935,680	$3,884,790
Operating Expenses	$2,913,729	$2,967,267	$3,260,650	$3,663,950	$3,873,832
Net Patient Income	-$21,933	$435,724	$134,664	$5,018	-$174,541
Net Patient Revenue	$2,891,796	$3,402,991	$3,395,314	$3,668,968	$3,699,291
Payroll Costs	$1,881,802	$1,939,044	$2,278,749	$2,154,227	$1,882,257
Operating Margin %	-0.8%	12.8%	4.0%	0.1%	-4.7%
Medicare %	8.5%	7.1%	6.1%	8.5%	6.1%
Medicaid %	62.4%	58.2%	57.8%	45.8%	47.1%
Private %	29.2%	34.8%	36.1%	45.7%	46.8%
Net Patient Revenue/Day	$214	$258	$253	$290	$278
Cost/Day	$215	$225	$243	$290	$291
Avg Length of Stay	270.8 days	220.0 days	609.6 days	632.2 days	459.4 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 09/2023.

Net patient revenue

$3.7M

Net patient income

-$174.5K

Nonprofit Nonprofit Corporation

Net patient revenue

$3.7M

Net patient income

-$174.5K

Other income

$144.4K

Payroll costs

$1.9M 50.9% of net patient revenue

Other operating costs

$2.0M

Total costs

$3.9M

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.

Coverage residents most often arrive under.

Medicare 59%

Private pay 32%

Medicaid 9%

Coverage residents most often leave under.

Medicare 34%

Private pay 31%

Medicaid 34%

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

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Info below is compiled from CMS reports & the SD Dept. of Health (DOH), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.


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Oakview Terrace	NH ADC AL IL MC	Freeman	45 Facility 45 SD AVG 69 Rank #82 / 117	78.7% Facility 78.7% SD AVG 82.2 Rank #26 / 34	-4%	4.79 Facility 4.79 SD AVG 4.34 Rank #13 / 65	+24%	+10%	$10.8k Facility $10.8k SD AVG $38.5k Rank #23 / 67	11 Facility 11 SD AVG 14.8 Rank #20 / 65	3.7 Facility 3.7 SD AVG 3.3 Rank #41 / 65	2	35	-	26 Facility 26 SD AVG 39 Rank #105 / 158	-	-	-	-	435112
Five Counties Nursing Home	NH AL IL SNF	W Lemmon	37 Facility 37 SD AVG 69 Rank #99 / 117	79.5% Facility 79.5% SD AVG 82.2 Rank #25 / 34	-3%	4.15 Facility 4.15 SD AVG 4.34 Rank #22 / 65	+84%	-4%	$20.7k Facility $20.7k SD AVG $38.5k Rank #37 / 67	34 Facility 34 SD AVG 14.8 Rank #59 / 65	5.7 Facility 5.7 SD AVG 3.3 Rank #58 / 65	2	30	-	42 Facility 42 SD AVG 39 Rank #71 / 158	-	$3.7MFiscal year ending 09/2023 Facility $3.7MFiscal year ending 09/2023 SD AVG $6.7M Rank #53 / 63	$1.9MFiscal year ending 09/2023 Facility $1.9MFiscal year ending 09/2023 SD AVG $2.6M Rank #46 / 63	50.9%Fiscal year ending 09/2023 Facility 50.9%Fiscal year ending 09/2023 SD AVG 40.8% Rank #11 / 63	435090

Nursing Home Explorer

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%.

Are pets allowed at Five Counties Nursing Home?

No, Five Counties Nursing Home has a no-pet policy.

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.

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Five Counties Nursing Home

Overview of Five Counties Nursing Home

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Therapy & Rehabilitation

Additional Policies & Features

Amenities & Lifestyle

Contact Five Counties Nursing Home

Health Inspection History

Inspections since 2022

Breakdown of citation severity (last 4 years)

Citations history (last 4 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

21 Certified Nursing Assistant

9 Registered Nurse

2 Medication Aide/Technician

2 Licensed Practical Nurse

1 Dietitian

1 Other Dietary Services Staff

1 Clinical Nurse Specialist

1 Mental Health Service Worker

1 Respiratory Therapy Technician

1 Physical Therapy Assistant

1 Occupational Therapy Aide

1 Other Physician

1 Medical Director

1 Diagnostic X-ray Services Staff

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Nurse Aide Training

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly short-term rehab stays

Admissions

Discharges

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