Federal inspection record · CMS data as of October 1, 2026
St William's Care Center
103 N Viola St, Milbank, SD · (605) 432-5811
- Certified beds
- 60
- Residents per day
- 49
- Ownership
- Non-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 15, 2005
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in South Dakota.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among South Dakota homes
St William's Care Center carries 101 inspection points. That is fewer than 17% of South Dakota's 94 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in South Dakota: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–14 pts
- 4★ 14–31.5 pts
- 3★ 31.5–55 pts
- 2★ 55–95.25 pts
- 1★ over 95.25 pts
Bars show every rated home in South Dakota by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
25 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (5)
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G
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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H
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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G
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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G
Respond appropriately to all alleged violations.
Everything else, by area of care
Pharmacy Service5E
- E
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.
- E
Ensure medication error rates are not 5 percent or greater.
- D
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.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
Nutrition and Dietary3F
- F
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Resident Assessment and Care Planning3E
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Rights3E
- E
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
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.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Freedom from Abuse, Neglect, and Exploitation3D
- D
Protect each resident from the wrongful use of the resident's belongings or money.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
Infection Control1F
- F
Provide and implement an infection prevention and control program.
Quality of Life and Care1D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Administration1D
- D
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspection history
2026-02-19
10 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2024-10-02
5 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Rights (2 deficiencies)
2023-08-10
10 health deficiencies · 0 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (6 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h of nursing staff time a day, 18 min of it from a registered nurse.
This home
3 h
South Dakota average
3 h 51 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 49% of nursing staff and 0% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$105,161 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-02-19 | Fine | $51,188 |
| 2024-10-02 | Fine | $12,048 |
| 2024-07-24 | Fine | $41,925 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.4 pts better | 1.1 | 1.5 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.7 pts better | 1.0 | 1.7 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine2.9 pts better | 97.8% | 94.9% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.8 pts better | 100.0% | 97.2% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.6 pts better | 3.9% | 5.5% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms4.3 pts worse | 10.2% | 5.9% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.9 pts better | 3.8% | 5.7% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.6 pts worse | 23.3% | 17.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medicationAbout the same | 24.8% | 24.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened0.7 pts better | 17.6% | 18.3% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased11.4 pts worse | 32.9% | 21.5% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.6 pts better | 1.3% | 1.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2.9 pts better | 0.0% | 2.9% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.5 pts worse | 25.0% | 24.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.1 pts worse | 4.6% | 4.5% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine0.6 pts worse | 83.3% | 83.9% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.2 pts better | 0.0% | 2.2% | 1.5% |
·
Who owns and runs it
11 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Butler, Rita | Corporate Director · Individual | 0% | 2 facilities |
| Butler, Rita | Adp Of The SNF · Individual | 0% | 2 facilities |
| Christenson, Ann | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Christenson, Ann | Adp Of The SNF · Individual | 0% | 1 facilities |
| Denna, Paul | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Denna, Paul | Adp Of The SNF · Individual | 0% | 1 facilities |
| Kosman, Janet | Corporate Director · Individual | 0% | 2 facilities |
| Thrift, Rene | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Thrift, Rene | Adp Of The SNF · Individual | 0% | 1 facilities |
| Walker, Mary | Adp Of The SNF · Individual | 0% | 1 facilities |
| Williams, Sharon | Corporate Officer · Individual | 0% | 2 facilities |
·
Fire safety
2 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke2D
- D
Inspect, test, and maintain automatic sprinkler systems.
- C
Have properly installed hallway dispensers for alcohol-based hand rub.
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Other homes nearby
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Avantara Milbank
Milbank, SD · Legacy Healthcare
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 21 min
- Fines
- $125,981
-
Fairway View Neighborhoods
Ortonville, MN · Abuse icon
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 4 h 43 min
- Fines
- $0
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Wilmot Care Center Inc
Wilmot, SD
★★★★★- Worst citation, 3 yrs
- L
- Nursing / resident / day
- 4 h 14 min
- Fines
- $28,028