SD · 66 Counties
South Dakota Rural Health FAQ
Data-driven answers about South Dakota's 67 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in South Dakota?
South Dakota has 67 active hospitals across 66 counties, including 39 Critical Access Hospitals and 46 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in South Dakota?
South Dakota's 67 hospitals collectively operate 3,996 beds. Source: CMS Provider of Services.
Which counties in South Dakota have no hospital?
21 of South Dakota's 66 counties (32%) are hospital deserts — counties with no hospital facility. Residents must travel to neighboring areas for inpatient care. Source: CMS Provider of Services, RHT Compass analysis.
What is the hospital ownership breakdown in South Dakota?
Of South Dakota's 67 hospitals, 15 are not-for-profit, 4 are for-profit, and 48 are government-owned. Source: CMS Provider of Services.
How many hospitals have closed in South Dakota?
3 rural hospitals have closed in South Dakota since 2005. Source: UNC Sheps Center for Health Services Research.
💰Financial Health
What is the median operating margin for hospitals in South Dakota?
The median operating margin for South Dakota's hospitals is -0.7% as of FY2025. 19 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in South Dakota have negative operating margins?
19 of South Dakota's hospitals reported negative operating margins in FY2025, meaning their operating expenses exceeded revenue. Source: CMS HCRIS.
What is the average hospital occupancy rate in South Dakota?
The average occupancy rate across South Dakota's hospitals is 32.6% as of FY2025. Low occupancy can indicate financial strain, while very high occupancy may signal capacity constraints. Source: CMS HCRIS.
💵Grants & Programs
What federal grants are available for rural hospitals in South Dakota?
South Dakota receives 19 active HRSA grants totaling $25.0M in FY2025. Programs include Rural Health Outreach ($14.9M), Flex Program ($4.9M), Small Hospital Improvement (SHIP) ($3.8M), State Office of Rural Health ($1.5M). Source: USAspending.gov.
What is the Rural Health Care Services Outreach program in South Dakota?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In South Dakota, this program (CFDA 93.912) provides $14.9M across 16 grants. Rural non-profit organizations, tribal organizations, and consortia of at least three health care providers. Source: USAspending.gov, HRSA.
What is the Medicare Rural Hospital Flexibility Grant (Flex) program in South Dakota?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In South Dakota, this program (CFDA 93.241) provides $4.9M across 1 grant. State offices of rural health apply on behalf of CAHs. Funds flow to state agencies, which distribute to eligible facilities. Source: USAspending.gov, HRSA.
What is the Small Hospital Improvement Program (SHIP) program in South Dakota?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In South Dakota, this program (CFDA 93.301) provides $3.8M across 1 grant. Hospitals with 49 or fewer beds that are not Critical Access Hospitals. Administered through state offices of rural health. Source: USAspending.gov, HRSA.
What is the State Offices of Rural Health (SORH) program in South Dakota?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In South Dakota, this program (CFDA 93.913) provides $1.5M across 1 grant. One award per state to the designated state office of rural health. Source: USAspending.gov, HRSA.
Who are the largest grant recipients in South Dakota?
The largest rural health grant recipients in South Dakota are: South Dakota Department Of Health ($10.1M); Avera Mckennan ($4.0M); South Dakota State University ($3.8M); Avera Health ($3.4M); Great Plains Tribal Leaders Health Board ($1.5M). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did South Dakota receive?
South Dakota receives $189.5M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $947.4M over the full five-year period. The lead agency is South Dakota Department of Health. Source: USAspending.gov.
Who manages the RHT Transformation award in South Dakota?
South Dakota Department of Health is the designated lead agency managing South Dakota's $189.5M/year RHT Transformation award. The performance period runs from 2025-12-29 to 2030-10-30. Source: USAspending.gov.
What is the CMS AHEAD model and how does it affect South Dakota?
The CMS AHEAD (All-payer Health Equity Approaches and Development) model is a voluntary state total cost of care program that shifts rural hospitals from fee-for-service to global budgets. South Dakota's $189.5M/year RHT award supports the transition. Hospitals can use the AHEAD Readiness checklist at rhtcompass.com/ahead to assess preparedness.
❤️Community Health
What are the key health indicators for South Dakota's counties?
Across South Dakota's 66 counties, the average diabetes rate is 9.5%, obesity rate is 36.8%, and uninsured rate is 11.1%. There are 6.2 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are South Dakota's communities?
South Dakota has 9 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.34 (on a 0-1 scale where 1 is most vulnerable). Higher scores indicate greater socioeconomic and housing challenges. Source: CDC SVI (2022).
What health professional shortages exist in South Dakota?
South Dakota has 316 Health Professional Shortage Area (HPSA) designations: 96 in primary care, 102 in dental health, and 118 in mental health. An estimated 4,147,327 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does South Dakota have?
South Dakota has 740 primary care physicians (80.5/100k population), 1,424 nurse practitioners, 762 physician assistants, and 606 dentists. Average Medicare per capita cost is $11,479 with a 15.2% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for South Dakota at the census tract level?
CDC PLACES data shows South Dakota's average county-level rates: diabetes 13.6%, obesity 37.1%, depression 20.9%, frequent mental distress 15.9%, smoking 18%, and high blood pressure 36.3%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in South Dakota?
South Dakota has 42 FQHC sites operated by 4 grantee organizations. 32 sites (76.2%) are in rural areas and 10 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in South Dakota?
South Dakota has 74 HRSA medically underserved designations: 69 Medically Underserved Areas (MUAs) and 5 Medically Underserved Populations (MUPs). The average MUA score is 50.1 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in South Dakota prepare for the CMS AHEAD model?
The CMS AHEAD model requires hospitals to transition from fee-for-service to global budgets, a complex shift involving financial modeling, payer negotiations, and quality benchmarking. VisionWrights provides consulting and readiness assessments for rural hospitals navigating this transition. A free AHEAD Readiness checklist is available at rhtcompass.com/ahead.
Where can I find comprehensive data on rural hospitals in South Dakota?
Federal data on South Dakota's rural hospitals is spread across CMS, HRSA, CDC, and other agencies. RHT Compass integrates 15 federal data sources into a single platform with hospital profiles, county health dashboards, financial benchmarks, and grant tracking for all 67 hospitals in South Dakota.
How can I assess my hospital's AHEAD readiness?
The free AHEAD Readiness checklist at rhtcompass.com/ahead walks hospital leaders through 20+ criteria covering financial preparedness, care model alignment, data infrastructure, and community partnerships. It takes about 10 minutes and produces an actionable readiness score.
See the Full South Dakota Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for South Dakota's 67 hospitals.
Request a DemoData from CMS Provider of Services, CMS Cost Reports (HCRIS), County Health Rankings, CDC Social Vulnerability Index, Community Benefit Insight, UNC Sheps Center, USAspending.gov, and HRSA Bureau of Health Workforce. Last updated: 2026-03-11.