Beresford, SD

Bethesda Of Beresford

3-star overall rating with 2-star inspections with $16,088 in total fines with 4 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle

606 W Cedar, Beresford, SD

(605) 763-2050

Compare this facility

Overall

3 / 5

CMS overall stars

Health inspections

2 / 5

Survey and complaint cycles

Staffing

4 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

Certified beds

Average residents

Average occupied residents

Ownership

Non-Profit

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

1994-09-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

1.06

Registered nurse staffing · state 0.80 · national 0.68

LPN hours / resident day

0.14

Licensed practical nurse staffing · state 0.49 · national 0.87

Aide hours / resident day

2.43

Nurse aide staffing · state 2.61 · national 2.35

Total nurse hours

3.63

All reported nurse hours · state 3.89 · national 3.89

Licensed hours

1.20

RN + LPN hours · state 1.28 · national 1.54

Weekend hours

3.06

Weekend nurse staffing · state 3.32 · national 3.43

Weekend RN hours

0.96

Weekend registered nurse coverage · state 0.51 · national 0.47

Physical therapist

0.03

Reported PT staffing · state 0.06 · national 0.07

Adjusted RN hours

1.08

CMS adjusted RN staffing hours

Adjusted total hours

3.72

CMS adjusted total nurse staffing hours

Case-mix index

1.34

Higher values indicate more complex resident acuity

RN turnover

33%

Annual RN turnover · state 39% · national 45%

Total nurse turnover

61%

Annual nurse turnover · state 50% · national 46%

SNF VBP

Value-based purchasing

Program rank

12,576

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

11.61

Composite VBP score used to determine payment impact.

Payment multiplier

0.9810

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Healthcare-associated infections

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Total nurse turnover

0.9

Baseline 65.12% · Performance 60.00% · Measure score 0.9 · Achievement 0.9 · Improvement 0.77

Adjusted total nurse staffing

1.42

Baseline 3.81 hours · Performance 3.48 hours · Measure score 1.42 · Achievement 1.42 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	Not Available	10.72%	Not Available · Eligible stays 24 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Discharge to community	Not Available	50.57%	Not Available · Eligible stays 17 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Medicare spending per beneficiary	1.2	1.02 0.2 pts worse
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 23 · Denominator 23
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 23
Discharge self-care score	47.83%	53.69% 5.9 pts worse	Numerator 11 · Denominator 23
Discharge mobility score	60.87%	50.94% 9.9 pts better	Numerator 14 · Denominator 23
Pressure ulcers or injuries, new or worsened	4.35%	2.29% 2.1 pts worse	Numerator 1 · Denominator 23 · Adjusted rate 4.05%
Healthcare-associated infections requiring hospitalization	Not Available	7.12%	Not Available · Eligible stays 14 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 56
Staff flu vaccination coverage	25%	42% 17 pts worse	Numerator 20 · Denominator 80
Discharge function score	56.52%	56.45% 0.1 pts better	Numerator 13 · Denominator 23
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator Not Available · Newly certified or not enough cases to report.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	0.8	1.5 0.7 pts better	1.9 1.1 pts better	Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.6 · Expected 1.5 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	0.9	1.9 1 pts better	1.8 0.9 pts better	Long Stay · 20240701-20250630 · Adjusted 0.9 · Observed 0.8 · Expected 1.4 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	95.4% 4.6 pts better	93.4% 6.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	100.0%	96.9% 3.1 pts better	95.5% 4.5 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury	1.6%	5.1% 3.5 pts better	3.3% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.2% · Q2 0.0% · Q3 0.0% · Q4 2.9% · 4Q avg 1.6% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	2.8%	4.6% 1.8 pts better	11.4% 8.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.0% · Q2 0.0% · Q3 4.2% · Q4 3.2% · 4Q avg 2.8%
Percentage of long-stay residents who lose too much weight	2.7%	5.5% 2.8 pts better	5.4% 2.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 3.8% · Q3 0.0% · Q4 3.4% · 4Q avg 2.7%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	24.3%	17.8% 6.5 pts worse	19.6% 4.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 28.6% · Q2 22.2% · Q3 20.7% · Q4 25.8% · 4Q avg 24.3%
Percentage of long-stay residents who received an antipsychotic medication	16.5%	25.1% 8.6 pts better	16.7% 0.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 15.4% · Q2 17.4% · Q3 16.7% · Q4 16.7% · 4Q avg 16.5% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	26.4%	21.3% 5.1 pts worse	16.3% 10.1 pts worse	Long Stay · 2024Q4-2025Q3 · 4Q avg 26.4% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	17.8%	21.6% 3.8 pts better	14.9% 2.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 19.2% · Q2 28.0% · Q3 7.4% · Q4 17.2% · 4Q avg 17.8% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.0%	2.0% 2 pts better	1.0% 1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.8%	3.3% 2.5 pts better	1.7% 0.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 3.1% · Q4 0.0% · 4Q avg 0.8% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	20.1%	25.8% 5.7 pts better	19.8% 0.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 25.8% · Q3 25.3% · Q4 20.0% · 4Q avg 20.1%
Percentage of long-stay residents with pressure ulcers	3.4%	4.6% 1.2 pts better	5.1% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 3.8% · Q3 3.4% · Q4 2.7% · 4Q avg 3.4% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	67.4%	83.2% 15.8 pts worse	81.7% 14.3 pts worse	Short Stay · 2024Q4-2025Q3 · 4Q avg 67.4%
Percentage of short-stay residents who newly received an antipsychotic medication	0.0%	1.7% 1.7 pts better	1.6% 1.6 pts better	Short Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-08-13 · Fire 2025-08-13

4 health deficiencies

Top issue: Quality of Life and Care (2 deficiencies)

2 fire-safety deficiencies

Top issue: Egress (1 deficiency)

Cycle 2 Health 2024-04-25 · Fire 2024-04-25

15 health deficiencies

Top issue: Resident Rights (6 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Cycle 3 Health 2023-04-05 · Fire 2023-04-05

6 health deficiencies

Top issue: Nutrition and Dietary (2 deficiencies)

1 fire-safety deficiencies

Top issue: Miscellaneous (1 deficiency)

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2025-08-13

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2025-09-27

D · Potential for more than minimal harm 2025-08-13

K293 · Egress Deficiencies

Fire Safety

Have properly located and lighted "Exit" signs.

Corrected 2025-09-27

E · Potential for more than minimal harm 2023-04-05

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2023-05-20

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-08-13

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2025-09-27

E · Potential for more than minimal harm 2025-08-13

F812 · Nutrition and Dietary Deficiencies

Health

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

Corrected 2025-09-27

D · Potential for more than minimal harm 2025-08-13

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-09-27

D · Potential for more than minimal harm 2025-08-13

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-09-27

E · Potential for more than minimal harm 2024-08-08

F625 · Resident Rights Deficiencies

Health

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.

Corrected 2024-08-30

F · Potential for more than minimal harm 2024-04-25

F725 · Nursing and Physician Services Deficiencies

Health

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

Corrected 2024-06-09

F · Potential for more than minimal harm 2024-04-25

F812 · Nutrition and Dietary Deficiencies

Health

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

Corrected 2024-06-09

F · Potential for more than minimal harm 2024-04-25

F851 · Administration Deficiencies

Health

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

Corrected 2024-06-09

F · Potential for more than minimal harm 2024-04-25

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-06-09

E · Potential for more than minimal harm 2024-04-25

F584 · Resident Rights Deficiencies

Health

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Corrected 2024-06-09

E · Potential for more than minimal harm 2024-04-25

F585 · Resident Rights Deficiencies

Health

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Corrected 2024-06-09

E · Potential for more than minimal harm 2024-04-25

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-06-09

E · Potential for more than minimal harm 2024-04-25

F909 · Environmental Deficiencies

Health

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.

Corrected 2024-06-09

E · Potential for more than minimal harm 2024-04-25

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2024-06-09

D · Potential for more than minimal harm 2024-04-25

F575 · Resident Rights Deficiencies

Health

Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.

Corrected 2024-06-09

D · Potential for more than minimal harm 2024-04-25

F577 · Resident Rights Deficiencies

Health

Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

Corrected 2024-06-09

D · Potential for more than minimal harm 2024-04-25

F578 · Resident Rights Deficiencies

Health

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Corrected 2024-06-09

D · Potential for more than minimal harm 2024-04-25

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2024-06-09

D · Potential for more than minimal harm 2024-04-25

F688 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Corrected 2024-06-09

G · Actual harm 2023-10-04

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-11-02

F · Potential for more than minimal harm 2023-10-04

F585 · Resident Rights Deficiencies

Health

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Corrected 2023-11-02

F · Potential for more than minimal harm 2023-04-05

F801 · Nutrition and Dietary Deficiencies

Health

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Corrected 2023-05-20

E · Potential for more than minimal harm 2023-04-05

F761 · Pharmacy Service Deficiencies

Health

Corrected 2023-05-20

E · Potential for more than minimal harm 2023-04-05

F812 · Nutrition and Dietary Deficiencies

Health

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

Corrected 2023-05-20

D · Potential for more than minimal harm 2023-04-05

F700 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2023-05-20

Penalties and ownership

What sits behind the stars

$16,088 2023-10-04

Fine

Fine · fine $16,088

Fine

Ownership

Antonson, Claire

Corporate Officer · Individual

0% 1 facilities 2021-04-14

Bethesda Of Beresford

Operational/Managerial Control · Organization

0% 1 facilities 2021-04-14

Fjerestad, Antoinette