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Custer Care and Rehab Center
1065 Montgomery St, Custer, SD 57730 (opens Google Maps) · Custer County · (605) 673-2115· 43 certified beds · avg — residents/day · certified since Dec 1, 2025 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
—/5
Health inspection rating (on-site)
inspected Aug 26, 2025
0
Serious findings on record
$0
Fines, last 3 years
—
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
New to these records? How to read an inspection report →
Health inspection rating: —/5 · CMS overall rating: —/5 · how star ratings work →
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.
Inspection findings in the public record
Showing the latest 3 of 17 inspection findings. Open the full record below to read every finding.
The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). F-0628
The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. F-0727
The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. F-0851
View all 17 inspection findingsShow only the latest 3 findings
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Aug 26, 2025 | F · Potential for more than minimal harm, widespread | The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). · F-0628 |
| Aug 26, 2025 | F · Potential for more than minimal harm, widespread | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727 |
| Aug 26, 2025 | F · Potential for more than minimal harm, widespread | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. · F-0851 |
| Aug 26, 2025 | F · Potential for more than minimal harm, widespread | The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them. · F-0865 |
| Aug 26, 2025 | F · Potential for more than minimal harm, widespread | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · F-0637 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. · F-0655 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · F-0657 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. · F-0757 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility did not designate a physician to serve as medical director — the doctor responsible for overseeing resident care policies and coordinating medical care across the facility. · F-0841 |
| Aug 26, 2025 | E · Potential for more than minimal harm, pattern | The facility's quality committee — the internal group responsible for finding and fixing care problems — did not have the required members or did not meet at least every three months. · F-0868 |
| Aug 26, 2025 | D · Potential for more than minimal harm, isolated | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · F-0644 |
| Aug 26, 2025 | D · Potential for more than minimal harm, isolated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656 |
| Aug 26, 2025 | D · Potential for more than minimal harm, isolated | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. · F-0700 |
| Aug 26, 2025 | D · Potential for more than minimal harm, isolated | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. · F-0732 |
| Aug 26, 2025 | D · Potential for more than minimal harm, isolated | The facility did not regularly inspect bed frames, mattresses, and bed rails for safety, or the rails and mattresses were not attached safely to the frames. · F-0909 |
Inspection trend by year
All citationsSerious citations (G–L)
2025
All citations: 17
Serious citations (G–L): 0
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2025 | 17 | 0 | F |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
Nurse staffing (from payroll records, adjusted for how much care residents need)
What these staffing numbers mean →
This facilitySouth Dakota averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: Not reported
South Dakota average: 4.32
U.S. average: 3.95
Registered Nurse hours
This facility: Not reported
South Dakota average: 0.91
U.S. average: 0.69
Weekend total nurse staffing
This facility: Not reported
South Dakota average: 3.71
U.S. average: 3.50
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | South Dakota avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | — | 4.32 | 3.95 | — |
| Registered Nurse hours | — | 0.91 | 0.69 | — |
| Weekend total nurse staffing | — | 3.71 | 3.50 | — |
| Weekend RN hours (not acuity-adjusted) | — | 0.51 | 0.48 | — |
| Total nursing staff turnover (%) | — | 48.2 | 45.8 | — |
| RN turnover (%) | — | 34.7 | 42.9 | — |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total —, RN —, weekend —.Comparing with Medicare Care Compare? Care Compare shows the raw figure (— here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: —/5.
Quality measures: assessments & claims
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: —/5 · long-stay residents: —/5 · short-stay residents: —/5
Costs & payment
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Custer Care and Rehab Center. CMS inspection and staffing records do not tell us what this home will charge you.
Calculate a stay from a quote you receive
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Before you compare prices
- Request the room type, effective date and itemized daily rate in writing.
- Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
- Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.
Understand who pays for care · How we handle price evidence · Report an incorrect price
Who owns this facility
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
Non profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Custer Cares | Organization | 5% or Greater Direct Ownership Interest | 100% | 12/01/2023 |
| Barta, Madison | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/01/2023 |
| Barta, Madison | Individual | ADP of the SNF | NOT APPLICABLE | 12/01/2023 |
| Boyer, Janet | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2023 |
| Custer Cares | Organization | ADP of the SNF | NOT APPLICABLE | 12/01/2023 |
| McGowan, Monica | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2023 |
| Tennyson, Mike | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2023 |
| Van Voorst, Samuel | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2023 |
| Van Voorst, Samuel | Individual | ADP of the SNF | NOT APPLICABLE | 09/01/2023 |
| Wheeler, Ricky | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2023 |
All 10 owning or managing parties CMS has on file are shown — none excluded.
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
- "How many hours a day is a registered nurse physically in the building, including weekends?"
- "How do your actual daily staffing levels compare to what's reported on Medicare's Care Compare website?"
- "How does your quality improvement program work, and can you share a recent example of a problem you found and fixed?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "If my family member's health suddenly changes, how quickly do you reassess them and update their care?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
Also worth asking anywhere
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the plan of correction for the findings in your most recent state inspection?"
- "Can I visit again unannounced, at a mealtime or on a weekend?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Michael J Fitzmaurice South Dakota Veterans Home | 23.6 mi | Hot Springs, SD | ★★☆☆☆ | 2/5 | |
| Seven Sisters Living Center | 25.0 mi | Hot Springs, SD | ★★★★☆ | 4/5 | |
| Clarkson Health Care | 25.3 mi | Rapid City, SD | ★★★★★ | 4/5 | |
| Avantara Arrowhead | 25.6 mi | Rapid City, SD | ★☆☆☆☆ | 1/5 | abuse |
| Westhills Village Health Care Facility | 26.6 mi | Rapid City, SD | ★★★★★ | 4/5 | |
| Avantara Mountain View | 27.0 mi | Rapid City, SD | ★★☆☆☆ | 2/5 | |
| Good Samaritan Society - St Martin Village | 27.2 mi | Rapid City, SD | ★★☆☆☆ | 2/5 | |
| Avantara Saint Cloud | 27.4 mi | Rapid City, SD | ★☆☆☆☆ | 2/5 | abuse |
| Fountain Springs Healthcare | 28.5 mi | Rapid City, SD | ★★★☆☆ | 3/5 | |
| Avantara North | 28.9 mi | Rapid City, SD | ★★★☆☆ | 3/5 | |
| Weston County Health Services | 30.4 mi | Newcastle, WY | ★★☆☆☆ | 2/5 | abuse |
Facility data as of CMS processing date 2026-08-01. CCN 435136.