Medicine Wheel Village

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Staffing

How full it usually is: this home is certified for 50 beds and averages 27.3 residents a day — about 55% occupied, or roughly 23 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.79 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.00 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.69 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 4.02 hrs/resident/day on weekends vs 5.11 on weekdays — 21% thinner on weekends — a notable drop. RN hours go from 1.11 to 0.72 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 31% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

27 citations, most serious first. The 11 most serious are shown; the remaining 16 are one tap away and print in full.

• Immediate jeopardy · Lcited before2025-11-20 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY A. Based on observation, interview, record review, manufacturer's instruction review, and policy review, the provider failed to ensure that staff followed standard food safety practices to sanitize dishware used to prepare and serve residents' food to prevent potential food-borne illness. That failure had the potential to affect all 28 residents who resided in the facility and placed them in immediate jeopardy for harm, illness, or death. Findings include: 1. Notice of immediate jeopardy of F812 was given verbally and in writing on 11/19/25 at 10:25 a.m. to administrator A regarding: *Observation on 11/19/25 at 9:00 a.m. revealed the commercial dishwasher in the kitchen was not working. *Interview on 11/19/25 at 9:20 a.m. with dietary manager F and maintenance staff AA revealed that the dishwasher stopped working 10/30/25 at about 10:23 a.m. and could not be repaired. A new dishwasher was ordered, received on 11/14/25, and was not installed as of 11/19/25. Dietary Manager F revealed all dishes were being washed…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-03-25 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on the South Dakota Department of Health (SD DOH) facility-reported incident (FRI), record review, interview, and policy review, the provider failed to protect the residents' right to be free from neglect for two of two sampled residents (1 and 2) by one of one certified nursing assistant (CNA) H who had not provided for the residents' activities of daily living needs. This failure resulted in resident 1 not being assisted with her toileting needs after using the call light and resident 2 developing moisture-associated skin damage to his buttock region. This citation is considered past non-compliance based on a review of the corrective actions the provider implemented following the incident. Findings include: 1. Review of the provider's submitted SD DOH FRI report revealed that on the night of 1/15/26 through the morning of 1/16/26, licensed practical nurse (LPN) C had difficulty with traveling certified nursing assistant (CNA) H providing care to residents. CNA H was refusing to answer residents' call…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Past Non-Compliance
• Potential for harm · Dcited before2026-03-25 · tag F0658 — failed to meet professional standards of care — isolated
  Ensure services provided by the nursing facility meet professional standards of quality.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on a South Dakota Department of Health (SD DOH) facility reported incident (FRI), record review, interviews, and policy review, the provider failed to ensure services were delivered according to professional standards. One physician (J) gave a verbal order to the director of nursing (DON) B to borrow a controlled medication from one resident (3) and administer it to another resident (4). As a result, licensed practical nurse (LPN E) removed resident 3's controlled medication and administered it to resident 4, which is considered unacceptable clinical practice and a violation of professional standards. This citation is considered past noncompliance based on the corrective actions implemented by the provider following the incident. Findings include:1. Review of the provider's submitted SD DOH FRI report revealed that on the night of 3/22/26, at approximately 8:50 p.m., DON B received a verbal telephone order from physician J. Physician J's order was documented in resident 4's electronic medical record for the nursing staff to follow. The physician's order was for resident 4 to…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Past Non-Compliance
• Potential for harm · F2025-11-20 · tag F0732 — widespread
  Post nurse staffing information every day.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, record review, and interview, the provider failed to post the required daily nursing staffing information in a location readily visible to residents, staff, and visitors that clearly reflected actual hours worked by the nursing staff for 18 of 18 days reviewed for November of 2025.Findings include: 1. Observation on 11/18/25 at 11:51 a.m. of the provider's Staffing Census Sheet revealed:*It was posted on the wall beside a door labeled staff only behind the 400 hall nurses' station.*It was hanging approximately six feet off the floor.*It included the date and resident census.*Under the Day Shift heading of that form numbers documented behind the RN (registered nurse), LPN (licensed practical nurse), CMA (certified medication aide), CNA (certified nursing assistant), and Restorative/Activity Aide areas.*Under the Night Shift heading of that form numbers were documented behind the RN, LPN, and CNA areas.*Those documented numbers were not identified as to what they represented.2. Interview on 11/18/25 at 11:51 a.m. with LPN/restorative nurse N revealed the Staffing…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-11-20 · tag F0808 — failed to follow doctor-ordered diets — widespread
  Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, observation, record review, and policy review, the provider failed to ensure nine of nine sampled residents (1, 2, 4, 5, 6, 7, 14, 17, and 18) were served foods in the appropriate form according to their physician-ordered therapeutic diets.Findings include: 1. Observation and interview on 11/18/25 at 12:01 p.m. with dietary aide T revealed: *He served whole chicken breasts, whole slices of ham, and cubed pieces of ham that were approximately one-inch pieces. *He did not have residents' diet cards to reference what the residents' ordered diets were. He explained that he had worked here for a year and had the residents' diets memorized and had a cheat sheet, so he knew which residents should be served the chicken breasts, as they were for residents on heart-healthy diets. *There was a list posted on a cupboard that listed all the residents' diet orders. *All the mechanical soft residents were served the cut-up ham. *He did not have any ground meat prepared to serve to residents. *He added…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2025-11-20 · tag F0657 — failed to keep the care plan current — pattern
  Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the provider failed to ensure the care plans were revised and individualized for one of one sampled resident (2) with schizophrenia, one of one sampled resident (8) who reported constant pain, and one of one sampled resident (21) who had a diagnosis of depression and anxiety and made statements of no longer wanting to live, to reflect their current needs.Findings include:1. Observation and interview on 11/18/25 at 8:00 a.m. with resident 21 in her room revealed:*She was sitting in her wheelchair beside her bed with her head lowered towards her chest.*She stated she was tired of doing the same things, so she sleeps all the time.*Resident 21 began to cry, and stated she did not want to live anymore.*She missed her children, and no one came to see her anymore.*She stated she had spoken to staff about not wanting to live anymore, and they reassured her and told her they were there to help her.*Resident 21 began to cry harder and stated she should…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2025-11-20 · tag F0700 — pattern
  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.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the provider failed to ensure ten of ten sampled residents (1, 2, 3, 7, 8, 14, 15, 17, and 20) who used side rails on their bed had alternatives attempted prior to the implementation of those side rails and four of ten sampled residents (3, 7, 8, and 17) with side rail son their beds were assessed for safe use of those rails within the last three months according to the provider's policy.Findings include: 1. Observation on 11/17/25 at 1:23 p.m. of resident 15's room revealed two quarter-length side rails in the up position at the head of her bed. Interview on 11/18/25 at 8:46 a.m. with resident 15 in her room revealed she: *Used both side rails to get out of bed, depending on which side of the bed she was getting out of. *Was provided education on the risks versus benefits of the side rails when she admitted to the facility. Review of resident 15's EMR revealed she: *Was admitted on [DATE]. *Had a 11/4/25 Brief Interview of Mental Status (BIMS)…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2025-11-20 · tag F0761 — failed to label and store drugs safely — pattern
  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.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and policy review, the provider failed to ensure temperatures were maintained within a proper temperature range for safe medication storage in one of one medication room.Findings include:1. Observation and interview on 11/20/25 at 12:32 p.m. with registered nurse (RN)/ staff development K in the medication room revealed:*She stated the facility had one medication room.*The medication room felt significantly warmer than the hallway outside the medication room.*There was documentation on the side of the refrigerator in the medication room which contained daily temperature readings from the refrigerator and freezer.*There was no documentation of temperatures for the medication room itself.*When asked if the temperature of the medication room were monitored, RN/staff development K pointed to the thermostat on the wall which was set at 72 degrees Fahrenheit (F).*RN/staff development K stated she did not know of any temperature monitoring or documentation for the medication room.2. Interview on 11/20/25 at 3:04 p.m. with RN/infection control (IC) C and…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2025-11-20 · tag F0880 — failed to prevent and control infections — pattern
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, observation, interview, and policy review, the provider failed to ensure infection control practices were followed by:*Two of two certified nursing assistants (CNAs) (X and Y) who did not wear a gown while providing direct resident cares to one of one sampled resident (4) on enhanced barrier precautions (EBP) for a pressure ulcer.*One of one nursing assistant (NA) (Z) who did not change gloves and perform hand hygiene (handwashing) when she changed a resident 5's incontinence brief and assisted her into her wheelchair.*One of one licensed practical nurse (LPN) applicant (P) who did not perform hand hygiene during an insulin administration to resident 23.*One of one registered nurse (RN)/Minimum Data Set (MDS)/skin and wound nurse (L) who did not perform hand hygiene when she changed resident 14's dressing.Findings include:1. Review of Resident 4's electronic medical record (EMR) revealed: *He was admitted on [DATE]. *He had diagnoses of a pressure ulcer (skin and/or underlying tissue…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-11-20 · tag F0565 — failed to support the resident council — isolated
  Honor the resident's right to organize and participate in resident/family groups in the facility.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on the resident council meeting, resident council meeting minutes review, grievance logs review, observation, interview, record review, and policy review, the provider failed to respond to the resident concerns communicated at resident council meetings regarding nursing care being performed in public and loud televisions. Findings include:1. A resident council meeting held on 11/19/25 at 2:12 p.m. revealed:*Residents voiced complaints that their concerns communicated during previous resident council meetings were not resolved, which included:-Loud televisions at night-Staff taking residents' vital signs, giving insulin injections, combing residents' hair, and fixing residents' clothing in shared common areas. *Complaints were heard by staff, but there was no follow-through.*Resident 17 reported, The loud televisions are so bothersome it makes me physically sick.2. A review of the providers' July-November 2025 resident council meeting minutes revealed:*On July 22, 2025, residents had concerns about televisions and radios being on and loud all night. -A 7/22/25 Grievance Log did…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-11-20 · tag F0609 — failed to report abuse allegations — isolated
  Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on resident council minutes review, interview, and policy review, the provider failed to ensure one of one certified nursing assistant (CNA)/activity staff (Q) who documented allegations of neglect regarding residents' personal care reported by residents, during an 11/12/25 resident council meeting reported those allegation to the administrator according to the provider's policy which resulted in those allegations not being reported to the South Dakota Department of Health (SD DOH) in the required time frame of no more than 24 hours after the allegations were made. Findings include: 1. Review of the provider's 11/12/25 resident council meeting minutes revealed: *Resident concerns/comments included: -Nursing-Resident's concerns, with some resident[s] that can't comb their own hair and wash their own faces are sometimes messy at meals and activity time. Also, that some resident[s] have their legs or stomachs showing when they come into [the] dinning [dining] room for meal[s] and for activities. Some residents are also concerned with how staff are sometimes seem to [too] busy and…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

$22,636 in federal fines across 1 penalty.

• $22,636 — penalty dated 2025-11-20

Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.

Who owns this facility

The source lists no ownership percentage for any party here — PECOS records a share only for equity interests, not for board or management roles.

What families pay in SD