Selling a skilled nursing facility in South Dakota
What moves the price of a South Dakota nursing home, how a sale runs from first call to change of ownership, and where to see the record for every South Dakota building.
South Dakota at a glance
South Dakota has 96 Medicare- and Medicaid-certified skilled nursing facilities with 5,848 certified beds, and on average 83.7% of those beds are occupied, above the national average of 80.3%.
Source: CMS Provider Information file, August 2026. The full South Dakota picture, rates and every building are on SNFRadar, the market record we built and publish free.
What a buyer reads first in South Dakota
The numbers a buyer pulls before the first call, for the typical South Dakota building against the nation. Your own building's are on its SNFRadar page.
Sources: CMS Provider Information file, August 2026 (occupancy, staffing, turnover, star ratings: averages across certified buildings); Medicare cost reports (full-year filings), as SNFRadar compares them (medians, the same figures each building's SNFRadar page is compared against).
What moves value in South Dakota
Occupancy. 83.7% of South Dakota's certified beds are occupied, above the national 80.3%. Full buildings are the norm here, so a buyer will ask why yours is not, or price in the referral strength if it is.
Payer mix and the Medicaid rate. Medicaid pays for 53% of resident days in the median South Dakota building, less than the national 66%. Medicare and private-pay residents carry more of the value here, so buyers weigh referral sources and short-stay results heavily. South Dakota's Medicaid rate files are on SNFRadar.
Revenue and margin. Net patient revenue runs $344 per patient day in the median South Dakota filing, below the national $373, and the median net margin is 3.8%, close to the national 3.6%. Value turns on whether your building beats its state's median, not on the state.
Staffing. South Dakota's buildings average 3.79 nurse staffing hours per resident per day, close to the national 3.86, and nurse turnover runs 48.2% a year against 45.8%. Buyers treat agency use and turnover as a cost they will inherit, so a stable staff is worth showing early.
Inspection record. 35% of South Dakota buildings are rated four or five stars by Medicare and 46% one or two, against 40% and 41% nationally. With low ratings common here, a clean inspection record stands out, and buyers pay for it.
Size and ownership type. The average South Dakota building has 61 certified beds, against 107 nationally. 32% are for-profit, 63% non-profit and 5% government, and 51% are part of a chain.
Where the beds are
South Dakota's largest counties by certified beds. Each opens that county's buildings on SNFRadar.
| County | Facilities | Certified beds |
|---|---|---|
| Minnehaha | 10 | 870 |
| Pennington | 9 | 599 |
| Brown | 5 | 381 |
| Yankton | 2 | 263 |
| Davison | 2 | 209 |
All 50 South Dakota counties
How a sale works
- A first call. What you want from the sale, and when. No listing, no blast.
- A value from the record. Your building's own numbers and the trades around it. How valuation works
- Vetted buyers under confidentiality, bidding against each other, not against you.
- Letter of intent, then the purchase agreement and the operations transfer agreement. The full process
- Change of ownership. South Dakota's licensure filings plus Medicare and Medicaid, timed so billing does not stop. CHOW and Medicaid
Our recent closings
One shot deal: $545 million.
A 5,000-bed skilled nursing portfolio across seven states in the Midwest and Southeast, sold for approximately $545 million.
Read the deal sheetAll five closings, with the press coverage they drew.
Questions owners ask
How many nursing homes are in South Dakota?
South Dakota has 96 Medicare- and Medicaid-certified skilled nursing facilities with 5,848 certified beds, according to the CMS Provider Information file (August 2026).
What is the average occupancy of South Dakota nursing homes?
On average 83.7% of certified beds in South Dakota are occupied, above the national average of 80.3% (CMS Provider Information, August 2026).
Do you work with sellers in South Dakota?
Yes. We advise skilled nursing sellers nationwide; our published closings so far are in Ohio, Mississippi, North Carolina and a seven-state portfolio across the Midwest and Southeast.
How much of South Dakota's nursing home care does Medicaid pay for?
In the median South Dakota building, Medicaid pays for 53% of resident days, against 66% nationally (Medicare cost reports (full-year filings), as SNFRadar compares them). That share is why South Dakota's Medicaid rate method decides so much of a building's value.
Are South Dakota nursing homes profitable?
The median South Dakota building that filed a full-year Medicare cost report shows a net margin of 3.8%, against 3.6% nationally. Margins vary widely from building to building; each building's own filing is on its SNFRadar page.
Is the first conversation confidential?
Yes. Nothing about you or your building goes to a buyer without your say.
Do you represent buyers?
No. We represent sellers. Buyers can share their acquisition criteria with us so we know who to call when a building fits; that does not make us their broker.

