Show Inspection Reports
Total health inspections
8
South Dakota average 4.5
Last Health inspection on Sep 2025
Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
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Nursing Home in South Dakota
CMS overall rating
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.
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.
Rolling Hills Healthcare
Nursing Home in South Dakota
CMS overall rating
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.
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.
Rolling Hills Healthcare
Overview of Rolling Hills Healthcare
Situated in the gorgeous town of Belle Fourche, South Dakota, Rolling Hills Healthcare offers a wide range of care options for seniors, including long term & short term care and rehab therapies. Whether you need physical, occupational, or speech therapy, their dedicated team is there to help. Seniors can enjoy the peaceful surroundings and friendly atmosphere of the community, making it a great place to relax and focus on wellness.
Rolling Hills Healthcare goes above and beyond in providing high-quality care with a personal touch. They aim to make every resident feel respected and well-cared-for by offering tailored care plans. The community features a variety of programs and amenities, including advanced therapies, pain management, dental care, dialysis, hospice services, and more. With a focus on individual wellness and rehabilitation, Rolling Hills Healthcare ensures that each resident receives the best possible care in a supportive and compassionate environment.
Gerald Bosen serves as the Administrator at Rolling Hills Healthcare, leading the community with a focus on personalized care and holistic healing. Under his leadership, the team prioritizes the safety and well-being of residents, especially during challenging times such as the COVID-19 pandemic, ensuring a family-like environment and customized therapy plans for each guest.
Quality ratings
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.
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.
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.
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.
Nursing care per resident
This shows how many total hours of nursing staff time are available per resident each day. Higher numbers usually mean more staff support.
Staffing hours breakdown
Hours of care per resident per day, broken down by staff type. Data from CMS Medicare.
Registered Nurse (RN)
Registered nurse hours per resident per day.
Registered nurse hours per resident per day.
Nurse Aide
Nurse aide hours per resident per day.
Nurse aide hours per resident per day.
Total Nursing (Weekend)
Total number of nurse staff hours per resident per day on weekends.
Total number of nurse staff hours per resident per day on weekends.
Physical Therapist
Physical therapist staff hours per resident per day.
Physical therapist staff hours per resident per day.
RN (Weekend)
Registered nurse hours per resident per day on weekends.
Registered nurse hours per resident per day on weekends.
Capacity and availability
Smaller home
May offer a more intimate, personalized care environment.
Total beds
83
This home usually has availability
Lower occupancy suggests more openings may be available.
Occupancy rate
63.1%
Residents per day (avg)
48
Occupancy rate
63.1%
Residents per day (avg)
48
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Might be optimal for
Short stays
Recovery
Medicare-covered care
Breakdown by payment type
Medicare
70% of new residents, usually for short-term rehab.
Typical stay
1 - 2 months
Private pay
23% of new residents, often for short stays.
Typical stay
6 - 7 months
Medicaid
7% of new residents, often for long-term daily care.
Typical stay
5 - 6 years
Finances and operations
Privately-owned community
Home revenue
$8.5M
Profit
$244.9K
Privately-owned community
Home revenue
$8.5M
Profit
$244.9K
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
$3.0M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$5.2M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$8.3M
83-bed community
A larger shared setting that may offer more common spaces and organized community services.
47 years in operation
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
Walk Score: 8 / 100
Car-dependent. Most errands require a car, with limited nearby walkable options.
BBB Rating: A+ (Not Accredited)
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
How BBB ratings work
How BBB ratings work
About this community
Facility TypeNursing Home
StatusActive
IssuanceJanuary 7, 2025
ExpirationJune 30, 2026
CountyButte
License Number10594
Rolling Hills Healthcare is administrated by Bosen, Gerald.
Staffing
Key information about the people who lead and staff this community.
ContactTracy Harwood, Executive Director
Accept Medicaid
Accept Medicare
Rehabilitation Services
Skilled Nursing
Licensed Professional Staff
Social Activities
Individualized Care Plans
Care Coordination
Dental Care
Dialysis
Hospice Care
Podiatry Services
Specific ProgramsSkilled Nursing, Rehabilitation Therapy, Long & Short Term Care
What does this home offer?
Building Type: Single-story
Fitness and Recreation
Types of Care at Rolling Hills Healthcare
Skilled Nursing
Access & Eligibility
Ways to qualify for care at this community, including accepted programs and payment options.
Medicaid Accepted
This facility is certified for eligible Medicaid services.
Medicare Accepted
This facility is certified for eligible Medicare services.
Inspection History
In South Dakota, the Department of Health, Office of Health Care Facilities Licensure is the state agency responsible for conducting unannounced surveys and monitoring facility quality.
9 visits/inspections
Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.
Latest inspection
Date
September 29, 2025
Complaint Investigation38 deficiencies
Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.
South Dakota average: 19 deficiencies
Inspection Report Summary for Rolling Hills Healthcare
The most recent inspection on September 29, 2025, identified deficiencies related to resident safety, trauma-informed care, and pharmaceutical services, including a burn from hot coffee, inadequate care planning for a resident with PTSD, and medication availability issues. Earlier inspections showed a pattern of issues involving resident care such as bathing assistance, medication management, environmental cleanliness, food service quality, and safety concerns including falls and elopement risks. Complaint investigations substantiated physical abuse by a staff member and other safety-related incidents, though enforcement actions like license suspensions or fines were not listed in the available reports. Most complaints were substantiated, with corrective actions taken, including staff termination and education. The facility’s inspection history shows ongoing challenges with resident care and safety, with no clear trend of consistent improvement or worsening over time.
Health Inspection History
Inspections
Total health citations
27
South Dakota average 14.8
Citations per inspection
3.38
South Dakota average 3.34
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
16 of 27 citations resulted from standard inspections; 10 of 27 resulted from complaint investigations; and 1 of 27 came from combined inspections (standard and complaint).
Breakdown of citation severity (last 3 years)
Critical Health citations
1
1
233% worse than South Dakota averageSouth Dakota average: 0.3
Serious Health citations
3
3
67% worse than South Dakota averageSouth Dakota average: 1.8
1 critical citation
3 serious citations
23 moderate citations
0 minor citations
Citations history (last 3 years)
Pharmacy moderate citation
Issues related to medication management, including how drugs are stored, administered, and monitored.
Sep 29, 2025
Issues related to medication management, including how drugs are stored, administered, and monitored.
Sep 29, 2025
Corrected
Quality of Care serious citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 29, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 29, 2025
Corrected
Quality of Care moderate citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 29, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 29, 2025
Corrected
Resident Rights moderate citation
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Jun 03, 2025
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Jun 03, 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.
Compare Nursing Homes around South Dakota The information below is reported by the South Dakota Department of Health, Office of Health Care Facilities Licensure.
Filter by care type
| Rolling Hills Healthcare |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
N Nursing | Belle Fourche (13Th Avenue) | 83 | 63.1% | -21% | 2.65 | -24% | -39% | 3 | 27 | 3.4 | 4 | 48 | A+ | 8 | - | $8.3M | $3.0M | 36.7% | 435035 |
Places of interest near Rolling Hills Healthcare
54.5 miles from city center
Estimated distance in miles from Belle Fourche's city center to Rolling Hills Healthcare's address, calculated via Google Maps.
— 0.8 miles to nearest hospital (Tri State Medical Center, PLLC)
Calculate Travel Distance to Rolling Hills Healthcare
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Staffing Data (Q2 2025)
This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
Total staff
60
Employees
49
Contractors
11
Staff to resident ratio
1.18:1
39% worse than South Dakota averageSouth Dakota average ratio: 1.91:1
Avg staff/day
21
Average shift
8.3 hours
8% better than South Dakota averageSouth Dakota average: 7.7 hours
Total staff hours (quarter)
15,841
Nursing staff breakdown
Registered Nurse
Manages medical care and health needs.
Total count
5
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursNo contractors work on this role.
Licensed Practical Nurse
Assists with medical care and medications.
Total count
5
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.5 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.5 hoursThis role is partially covered by contractors.
Certified Nursing Assistant
Helps with daily care and mobility.
Total count
27
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursThis role is partially covered by contractors.
Contractor staffing
Total hours from contractors
15.3%
2,430 contractor hours this quarter
Certified Nursing Assistant: 8
Licensed Practical Nurse: 2
Physical Therapy Aide: 1
Staff by category
| Certified Nursing Assistant | 19 | 8 | 27 | 6,303 | 91 | 100% | 8.4 |
| Medication Aide/Technician | 6 | 0 | 6 | 1,552 | 91 | 100% | 9.6 |
| Licensed Practical Nurse | 3 | 2 | 5 | 1,344 | 85 | 93% | 10.5 |
| Physical Therapy Aide | 3 | 1 | 4 | 1,162 | 78 | 86% | 7.3 |
| Registered Nurse | 5 | 0 | 5 | 1,057 | 87 | 96% | 8.4 |
| Dental Services Staff | 1 | 0 | 1 | 609 | 66 | 73% | 9.2 |
| Respiratory Therapy Technician | 2 | 0 | 2 | 575 | 69 | 76% | 8 |
| Qualified Social Worker | 1 | 0 | 1 | 503 | 63 | 69% | 8 |
| Dietitian | 1 | 0 | 1 | 500 | 63 | 69% | 7.9 |
| Mental Health Service Worker | 1 | 0 | 1 | 496 | 62 | 68% | 8 |
| Speech Language Pathologist | 2 | 0 | 2 | 455 | 61 | 67% | 7.1 |
| Administrator | 1 | 0 | 1 | 440 | 55 | 60% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 418 | 55 | 60% | 7.6 |
| RN Director of Nursing | 1 | 0 | 1 | 232 | 29 | 32% | 8 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 192 | 24 | 26% | 8 |
| Nurse Aide in Training | 1 | 0 | 1 | 4 | 1 | 1% | 4 |
27 Certified Nursing Assistant
% of Days
100%
6 Medication Aide/Technician
% of Days
100%
5 Licensed Practical Nurse
% of Days
93%
4 Physical Therapy Aide
% of Days
86%
5 Registered Nurse
% of Days
96%
1 Dental Services Staff
% of Days
73%
2 Respiratory Therapy Technician
% of Days
76%
1 Qualified Social Worker
% of Days
69%
1 Dietitian
% of Days
69%
1 Mental Health Service Worker
% of Days
68%
2 Speech Language Pathologist
% of Days
67%
1 Administrator
% of Days
60%
1 Nurse Practitioner
% of Days
60%
1 RN Director of Nursing
% of Days
32%
1 Clinical Nurse Specialist
% of Days
26%
1 Nurse Aide in Training
% of Days
1%
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
51
Medicare
25
49% of residents
Medicaid
26
51% of residents
Programs & Services
Residents Group
Residents meet regularly to discuss policies, care quality, and activities
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.
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
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
13.6
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
13.6
13% worse than South Dakota averageSouth Dakota average: 12.0
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
28.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
28.2
18% worse than South Dakota averageSouth Dakota average: 23.9
Long-stay resident measures
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
Percent of long-stay residents whose need for help with daily activities has increased
18.5%
Percent of long-stay residents whose need for help with daily activities has increased
18.5%
17% better than South Dakota averageSouth Dakota average: 22.3%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
28.6%
Percent of long-stay residents whose ability to move independently worsened
28.6%
25% worse than South Dakota averageSouth Dakota average: 22.8%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
37.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
37.6%
41% worse than South Dakota averageSouth Dakota average: 26.7%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
3.4%
Percent of long-stay residents experiencing one or more falls with major injury
3.4%
33% better than South Dakota averageSouth Dakota average: 5.0%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
5.8%
Percent of long-stay high risk residents with pressure ulcers
5.8%
28% worse than South Dakota averageSouth Dakota average: 4.5%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
8.2%
Percent of long-stay residents with a urinary tract infection
8.2%
136% worse than South Dakota averageSouth Dakota average: 3.5%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
12.0%
Percent of long-stay residents who lose too much weight
12.0%
121% worse than South Dakota averageSouth Dakota average: 5.5%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
0.0%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than South Dakota averageSouth Dakota average: 4.1%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
13.4%
Percent of long-stay residents who received an antipsychotic medication
13.4%
45% better than South Dakota averageSouth Dakota average: 24.4%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
5% better than South Dakota averageSouth Dakota average: 95.7%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.0%
In line with South Dakota averageSouth Dakota average: 96.9%
Hospitalizations per 1,000 days
Number of hospitalizations per 1,000 long-stay resident days.
0.62
Number of hospitalizations per 1,000 long-stay resident days.
0.62
59% better than South Dakota averageSouth Dakota average: 1.51
ED visits per 1,000 days
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.34
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.34
26% worse than South Dakota averageSouth Dakota average: 1.85
Short-stay resident measures
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
94.9%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
94.9%
12% better than South Dakota averageSouth Dakota average: 84.4%
Antipsychotic medication increase
Percent of short-stay residents who newly received an antipsychotic medication
1.4%
Percent of short-stay residents who newly received an antipsychotic medication
1.4%
20% better than South Dakota averageSouth Dakota average: 1.8%
Influenza Vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
91.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
91.4%
17% better than South Dakota averageSouth Dakota average: 78.2%
Re-hospitalized after SNF stay
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
16.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
16.3%
24% better than South Dakota averageSouth Dakota average: 21.5%
Emergency department visits
Percentage of short-stay residents who had an outpatient emergency department visit.
13.1%
Percentage of short-stay residents who had an outpatient emergency department visit.
13.1%
12% worse than South Dakota averageSouth Dakota average: 11.7%
Falls with major injury
Percentage of SNF residents who experience falls with major injury during their stay.
1.8%
Percentage of SNF residents who experience falls with major injury during their stay.
1.8%
136% worse than South Dakota averageSouth Dakota average: 0.8%
Ability to care for self at discharge
Percentage of residents at or above expected ability to care for themselves at discharge.
35.9%
Percentage of residents at or above expected ability to care for themselves at discharge.
35.9%
33% worse than South Dakota averageSouth Dakota average: 53.7%
Successful return to home or community
Rate of successful return to home or community from a skilled nursing facility.
55.1%
Rate of successful return to home or community from a skilled nursing facility.
55.1%
9% better than South Dakota averageSouth Dakota average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Penalties and fines
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
$71K
78% higher than South Dakota averageSouth Dakota average: $40K
Number of fines
3
48% more fines than South Dakota averageSouth Dakota average: 2.0
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
In line with South Dakota averageSouth Dakota average: 0.0
Fines amount comparison
Fines amount comparison
This facility
$71K
South Dakota average
$40K
Penalty History
Penalties are imposed by CMS for violations of federal nursing home regulations.
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 28, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 28, 2025
$14K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 17, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 17, 2024
$26K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Sep 4, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Sep 4, 2024
$31K
Last updated: Jan 2026
Financial Trends
Historical financial and operational data for Rolling Hills Healthcare based on CMS SNF Cost Reports.
Occupancy Rate
63.1%
↓ 2.2pp vs 2022
Net Income
$244.9K
↓ ~$1.4M vs 2022
Total Payroll
$4.3M
↑ ~$540.3K vs 2022
Profit Margin
3.0%
↓ 15.0pp vs 2022
Loading trend charts...
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