These are the lowest-rated nursing homes in South Dakota based on CMS data (2026). The lowest CMS rating in this list is 1 star(s). Combined, these 20 facilities have been fined a total of $1,452,078. 5 have abuse flags. This ranking is based solely on official CMS data and does not represent editorial opinion.
| # | Name | City | Overall | Fines |
|---|---|---|---|---|
| 1 | Avantara Milbank | Milbank | $55,361 | |
| 2 | Rolling Hills Healthcare | Belle Fourche | $80,634 | |
| 3 | Aberdeen Health and Rehab | Aberdeen | $64,270 | |
| 4 | Good Samaritan Society Sioux Falls Village | Sioux Falls | $72,812 | |
| 5 | Avantara Arrowhead | Rapid City | $82,863 | |
| 6 | Avantara Watertown | Watertown | $6,368 | |
| 7 | Riverview Healthcare Center | Flandreau | $176,867 | |
| 8 | Five Counties Nursing Home | Lemmon | $20,703 | |
| 9 | Lake Andes Senior Living | Lake Andes | $102,440 | |
| 10 | Firesteel Healthcare Center | Mitchell | $153,308 | |
| 11 | Diamond Care Center | Bridgewater | $69,512 | |
| 12 | Palisade Healthcare Center | Garretson | $154,946 | |
| 13 | Wilmot Care Center Inc | Wilmot | $28,028 | |
| 14 | Bethany Home - Brandon | Brandon | $51,350 | |
| 15 | Avera Mother Joseph Manor Retirement Community | Aberdeen | $8,824 | |
| 16 | Avantara Saint Cloud | Rapid City | $24,751 | |
| 17 | Good Samaritan Society De Smet | De Smet | $27,989 | |
| 18 | Good Samaritan Society Miller | Miller | $96,127 | |
| 19 | Sanford Chamberlain Care Center | Chamberlain | $124,961 | |
| 20 | Strand-Kjorsvig Community Rest Home | Roslyn | $49,964 |
Rankings are based on the CMS 5-Star Quality Rating System, which evaluates nursing homes on health inspections, staffing, and quality measures. Ratings range from 1 star (much below average) to 5 stars (much above average). Data is updated monthly by CMS.