South Dakota's statewide staffing ratio is 3.76 HPRD in Q1 2026. South Dakota's statewide staffing ratio is down slightly (−0.01) since Q1 2025. This level is near the national ratio of 3.75 HPRD and ranks #30 out of 51 states.
South Dakota
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
South Dakota
South Dakota
South Dakota
22 facilities flagged for staffing or quality concerns.
| Facility | City | CMS ratings | Risk flags | Total HPRD |
|---|---|---|---|---|
| Aberdeen Health and RehabAberdeen | Aberdeen | 1★ | 3.61 HPRD | |
| Avantara ArrowheadRapid City | Rapid City | 1★ | 3.52 HPRD | |
| Avantara MilbankMilbank | Milbank | 1★ | 3.23 HPRD | |
| Avantara NortonSioux Falls | Sioux Falls | SFF⚠ | 3.86 HPRD | |
| Avantara Saint CloudRapid City | Rapid City | ⚠1★1★S | 3.12 HPRD |
Latest state staffing metrics for South Dakota.
| Metric | South Dakota | CMS Region 8CMS Region 8 includes Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.Regional figures are calculated from facility-level data using the same methodology as the state figures. | U.S. | State rankRanks compare the 50 states and D.C. by the displayed metric value. A higher or lower rank is not inherently positive or negative for every metric, including contract staffing share and rural-facility share. |
|---|---|---|---|---|
| Total Nurse Staffing HPRD | 3.76 | 3.82+0.05 vs SD | 3.75-0.02 vs SD | #30 of 51 |
| Direct Care Nurse HPRD | 3.47 | 3.55+0.09 vs SD | 3.48+0.01 vs SD | #30 of 51 |
| RN HPRD | 0.79 | 0.86+0.07 vs SD | 0.62-0.17 vs SD | #15 of 51 |
| RN Direct Care HPRD | 0.53 | 0.64+0.11 vs SD | 0.44-0.09 vs SD | #18 of 51 |
| Nurse Aide HPRD | 2.49 | 2.37-0.12 vs SD | 2.26-0.23 vs SD | #17 of 51 |
| Contract Staff Percentage | 9.1% | 7.3%-1.8 pts vs SD | 5.3%-3.8 pts vs SD | #11 of 51 |
| Median Case-Mix HPRD (Acuity) | 3.37 | 3.52+0.15 vs SD | 3.74+0.37 vs SD | #43 of 51 |
| Rural Facilities (Share) | 70% | 45%-24.4 pts vs SD | 27%-42.5 pts vs SD | #5 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
Largest organizations linked to facilities in CMS owner data.
Most facilities linked in CMS owner data (South Dakota).
Recent CMS change-of-ownership activity.
27 ownership changes at 27 South Dakota facilities · 01/01/2016 – 02/01/2026.
Showing 10 of 27
Daily PBJ data, employee rosters, and facility-level analysis.
Staffing from CMS Payroll-Based Journal (PBJ) public files (2017–2026), plus Provider Information and chain data where shown. State staffing context via MACPAC (2022). Methodology · PBJ explained.
Metrics
Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.
Data transparency
The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.
Trend charts omit quarters with implausible submitted HPRD (total/direct below 0.25; RN, LPN, and aide use role floors and neighbor-quarter rules). Full criteria.
Rankings, within-state percentiles, CMS flags (including abuse icon): How metrics are calculated.