PIERRE, S.D. Complaints against South Dakota nursing homes are the highest they’ve been in at least eight years.
The state Department of Health oversees 97 long-term care facilities, according to its website, It fielded 54 complaints as of Dec. 19 – a 38% increase over 2022 and three times higher than 2021 and 2020, when the state received 18 complaints each year.
Both 2021 and 2020 saw COVID lockdowns at long-term care facilities across the state and nation, keeping family members from facilities and residents.
Most complaints in 2023 concern quality of life and care, neglect and abuse, and nursing services. In just over two-thirds of the cases, inspections found no violations.
Of the complaints deemed credible, many involved a lack of adequate care and documentation for residents after a fall or change in health condition.
Federal and state law require long-term care facilities create a “plan of correction” if inspectors find a deficiency.
One facility, Avantara Redfield, had a broken bathtub for months and wasn’t washing residents often enough, leaving some without a shower for two or three weeks. The nursing home fixed the bathtub within a month of the complaint investigation, educated its staff about hygiene and conducted an audit of bathing schedules.
A resident who contracted pneumonia and fell ill at another facility, Avantara Norton, saw a doctor, but staff didn’t notify his family of his condition until after his death.
Nearly a third of all complaints in 2023 were lodged against Avantara facilities. Avantara operates 17 of the state’s 97 nursing homes. Good Samaritan operates the second-most facilities in South Dakota, with 16 nursing homes (13% of 2023 complaints), and Avera operates 10 (4% of 2023 complaints).
The number of complaints in 2023 is higher than the pre-pandemic average. Complaints between 2015 and 2019 averaged 32 per year, with a high of 49 in 2017.
The nursing home worker shortage in South Dakota and across the country has been well documented, with many facilities relying on traveling nurses to fill roles.
Seven nursing homes announced they were closing in 2022, often citing costs, low Medicaid reimbursement rates and workforce shortages as reasons. In 2023, only one announced a closure so far, although three closed in 2023 after previously announcing their intentions to close.
Bennett County Nursing Home closed in October. The Martin-based facility lost over $1.3 million in the first half of 2023, CEO and Bennett County Hospital Administrator Michael Christensen wrote in an open letter to The Lakota Times.
The nursing home had a staff turnover rate of 94.4%. The average state nursing home staff turnover rate in South Dakota is 52.9%. The nursing home relied heavily on costly travel nurses, with only a few local nurses working at the facility. The letter also said nursing homes like Bennett County have seen expenses rise 1,064% since the beginning of the pandemic.
The Legislature approved an increase to a 100% Medicaid cost reimbursement rate this year for community support providers that rely on government funding, such as nursing homes. That’s led to a 25% increase in nursing home funding, according to state officials.
The Legislature also formed an interim committee to study long term care in the state and recommend legislation to address the issue this coming January. Recommendations that would affect nursing homes include establishing a one-time $5 million technology grant program, creating a reimbursement program to incentivize nursing home mergers and creating a waiver to let long-term care facilities double ast adult day cares.
Gov. Kristi Noem proposed a 4% increase in state funding to health care providers next year in her budget address earlier this month.