PlainNursing
CMS Nursing Home Compare · March 2026

Five Counties Nursing Home

405 6th Avenue West, Lemmon, SD 57638

Five Counties Nursing Home, a 42-bed non profit - corporation nursing facility in Lemmon, SD, holds a 1-star CMS overall rating - below the 3.0-star national average, with nurse staffing below the national norm. 2 inspection findings reached the actual-harm or immediate-jeopardy level.

CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating, read the components below; they often tell a sharper story than the headline.

Phone: 6053743871

Build a private shortlist as you compare, saved on this device, no account needed.

1 / 5
Much below average · CMS overall · nat'l 3.0
3.02
Well below average · nurse hrs/day · nat'l 3.89
34
Inspection findings · 2 serious
$32K
Federal penalties (1)

Health Inspection

1/5

Staffing

3/5

Quality Measures

1/5

Long-Stay Quality

1/5

Facility Information

Provider Number
435090
Ownership
Non profit - Corporation
Provider Type
Medicare and Medicaid
Beds
42
Residents
32
In Hospital
No
County
Perkins
Last Inspection
Mar 12, 2025
Special Focus
SFF Candidate

Staffing Data

How the 3.02 total nursing hours per resident-day are staffed:

RN Hours
0.86 (nat'l avg: 0.68)
LPN Hours
0.19
CNA Hours
1.97
Total Nursing Hours
3.02 (nat'l avg: 3.89)
PT Hours
0.04
Nursing Turnover
65.5%
RN Turnover
87.5%

What the CMS Record Reveals About Five Counties Nursing Home

Five Counties Nursing Home operates 42 certified beds in Lemmon, SD with approximately 32 residents currently in care, and carries a CMS overall rating of 1 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (1★), staffing levels (3★), and quality measures (1★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone, a 3-star facility with weak inspection history reads differently from one held back by thin staffing.

The inspection file contains 34 deficiency records from recent surveys, of which 2 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 1 penalty totaling $32K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 3.02 total nursing hours per resident day (national average 3.89), with RN coverage at 0.86 per resident day, the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature. This facility is currently designated "SFF Candidate" under the CMS Special Focus Facility program, reserved for providers with a persistent pattern of serious quality problems.

Classified as "Non profit - Corporation" ownership and operating as a "Medicare and Medicaid" provider, Five Counties Nursing Home falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes, ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 65.5%, above the level where continuity of care typically begins to suffer. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report, the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.

Deficiency History (34 most recent)

D - Isolated - Minimal harm May 15, 2025 Tag: 0689

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Category: Quality of Life and Care Deficiencies

Corrected: May 27, 2025

E - Pattern - Minimal harm Apr 9, 2025 Tag: 0761

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Category: Pharmacy Service Deficiencies

Corrected: May 2, 2025

G - Isolated - Actual harm Apr 9, 2025 Tag: 0760

Ensure that residents are free from significant medication errors.

Category: Pharmacy Service Deficiencies

Corrected: May 2, 2025

G - Isolated - Actual harm Apr 9, 2025 Tag: 0686

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Category: Quality of Life and Care Deficiencies

Corrected: May 2, 2025

D - Isolated - Minimal harm Apr 9, 2025 Tag: 0658

Ensure services provided by the nursing facility meet professional standards of quality.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: May 27, 2025

D - Isolated - Minimal harm Apr 9, 2025 Tag: 0610

Respond appropriately to all alleged violations.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: May 27, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0909

Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.

Category: Environmental Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0865

Have a plan that describes the process for conducting QAPI and QAA activities.

Category: Administration Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0851

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

Category: Administration Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0848

Provide a neutral and fair arbitration process and agree to arbitrator and venue.

Category: Administration Deficiencies

Corrected: May 7, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0847

Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.

Category: Administration Deficiencies

Corrected: May 7, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0837

Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.

Category: Administration Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0835

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

Category: Administration Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0812

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Category: Nutrition and Dietary Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0761

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Category: Pharmacy Service Deficiencies

Corrected: Apr 26, 2025

D - Isolated - Minimal harm Mar 12, 2025 Tag: 0758

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Category: Pharmacy Service Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0755

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Category: Pharmacy Service Deficiencies

Corrected: May 27, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0732

Post nurse staffing information every day.

Category: Nursing and Physician Services Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0727

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Category: Nursing and Physician Services Deficiencies

Corrected: Apr 26, 2025

F - Widespread - Minimal harm Mar 12, 2025 Tag: 0725

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Category: Nursing and Physician Services Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0700

Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

Category: Quality of Life and Care Deficiencies

Corrected: May 8, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0699

Provide care or services that was trauma informed and/or culturally competent.

Category: Quality of Life and Care Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0658

Ensure services provided by the nursing facility meet professional standards of quality.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0655

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Apr 26, 2025

D - Isolated - Minimal harm Mar 12, 2025 Tag: 0610

Respond appropriately to all alleged violations.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: May 27, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0583

Keep residents' personal and medical records private and confidential.

Category: Resident Rights Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Mar 12, 2025 Tag: 0582

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Category: Resident Rights Deficiencies

Corrected: Apr 26, 2025

E - Pattern - Minimal harm Jan 22, 2025 Tag: 0684

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Category: Quality of Life and Care Deficiencies

Corrected: Feb 7, 2025

D - Isolated - Minimal harm Dec 6, 2023 Tag: 0758

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Category: Pharmacy Service Deficiencies

Corrected: Jan 20, 2024

E - Pattern - Minimal harm Dec 6, 2023 Tag: 0692

Provide enough food/fluids to maintain a resident's health.

Category: Quality of Life and Care Deficiencies

Corrected: Jan 20, 2024

E - Pattern - Minimal harm Dec 6, 2023 Tag: 0678

Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.

Category: Quality of Life and Care Deficiencies

Corrected: Jan 20, 2024

E - Pattern - Minimal harm Dec 6, 2023 Tag: 0658

Ensure services provided by the nursing facility meet professional standards of quality.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Jan 20, 2024

D - Isolated - Minimal harm Dec 6, 2023 Tag: 0625

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Category: Resident Rights Deficiencies

Corrected: Jan 20, 2024

E - Pattern - Minimal harm Nov 3, 2022 Tag: 0700

Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

Category: Quality of Life and Care Deficiencies

Corrected: Dec 23, 2022

Quality Measures

Measure Type Score Used in Rating
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay 27.1% Yes
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay 2.5% Yes
Percentage of long-stay residents with a urinary tract infection Long Stay 3.6% Yes
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay 9.9% Yes
Percentage of long-stay residents whose ability to walk independently worsened Long Stay 24.1% Yes
Percentage of long-stay residents with pressure ulcers Long Stay 2.5% Yes
Percentage of long-stay residents who received an antipsychotic medication Long Stay 16.8% Yes
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay 4.3% Yes
Percentage of long-stay residents who lose too much weight Long Stay 8.0% No
Percentage of long-stay residents who have depressive symptoms Long Stay 2.3% No
Percentage of long-stay residents who were physically restrained Long Stay 0.0% No
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Long Stay 83.0% No
Percentage of long-stay residents who received an antianxiety or hypnotic medication Long Stay 15.6% No
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Long Stay 95.2% No
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Long Stay 24.8% No
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Short Stay 63.8% No
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Short Stay N/A No

Penalty History 1 penalties totaling $32K

Date Type Amount
Mar 12, 2025 Fine $32K

Frequently Asked Questions

What is the overall CMS rating for Five Counties Nursing Home?
Five Counties Nursing Home has an overall CMS rating of 1 out of 5 stars. This rating combines health inspection results (1★), staffing levels (3★), and quality measures (1★).
What are the staffing levels at Five Counties Nursing Home?
Five Counties Nursing Home reports 3.02 total nursing hours per resident day (national average: 3.89). RN hours are 0.86 per resident day (national average: 0.68). Nursing staff turnover is 65.5%.
How many beds does Five Counties Nursing Home have?
Five Counties Nursing Home has 42 certified beds with approximately 32 residents. The facility is located at 405 6th Avenue West, Lemmon, SD 57638.
Does Five Counties Nursing Home have any deficiencies on record?
Yes, Five Counties Nursing Home has 34 deficiencies on record from recent inspections. Of these, 2 are classified as causing actual harm or jeopardy.
Has Five Counties Nursing Home received any fines or penalties?
Yes, Five Counties Nursing Home has received 1 penalties totaling $32K.
Who owns Five Counties Nursing Home?
Five Counties Nursing Home is classified as "Non profit - Corporation" ownership. The facility type is "Medicare and Medicaid".
When was Five Counties Nursing Home last inspected?
The most recent health inspection for Five Counties Nursing Home was on Mar 12, 2025. The facility received a health inspection rating of 1 out of 5 stars.
What quality measures are tracked for Five Counties Nursing Home?
Five Counties Nursing Home is evaluated on 17 quality measures, of which 8 are used in the CMS star rating calculation. These include measures for both long-stay and short-stay residents covering areas like infections, falls, pressure ulcers, and medication use.

Data Sources

Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.

Source: CMS Nursing Home Compare provider data (data.cms.gov). See our methodology for how this page is compiled. Ratings, staffing, health-inspection deficiency, and Civil Money Penalty records are published by the Centers for Medicare & Medicaid Services under a public-domain (CC0) license.

Found this useful? Share Five Counties Nursing Home's record.