SIOUX FALLS — Two South Dakota hospitals received below-average scores in the U.S. Centers for Medicare & Medicaid Services’ (CMS) 2026 Overall Hospital Quality Star Ratings, while several others improved or held strong in the federal assessment released this year.
Who landed where
The CMS ratings, which combine multiple measures of hospital performance into an overall star score, placed Avera St. Mary’s Hospital in Pierre and Huron Regional Medical Center in the two-star — or below-average — category. Meanwhile, five state hospitals earned the highest 5-star rating, an increase from three in last year’s ratings. Among those five is the VA Healthcare System in Sturgis.
| Star rating | South Dakota hospitals (not exhaustive) |
|---|---|
| 5 stars | 5 hospitals (including VA Healthcare System, Sturgis) |
| 2 stars | Avera St. Mary’s Hospital (Pierre); Huron Regional Medical Center |
| 1 star | No South Dakota hospitals received a 1-star rating in 2026 |
How the ratings are calculated
CMS compiles the Overall Hospital Quality Star Ratings from a range of measures including mortality, patient safety, readmissions, patient experience and timely, effective care. The agency aggregates and weights those measures to produce an overall score intended to help consumers compare hospitals.
Reaction from state health leaders and hospitals
Tim Rave, CEO of the South Dakota Association of Healthcare Organizations, urged caution in reading the results. He said the ratings are a useful benchmark but are only one snapshot of performance, noting that some underlying federal data can be several years old.
Officials at Avera, Monument Health and Huron Regional told NEXO RADAR that they are continuing efforts to improve patient care and outcomes. Hospital leaders emphasized ongoing quality initiatives and said they review the federal metrics as part of their improvement work.
What this means for patients
For patients and families, the star ratings are meant to be a starting point when evaluating hospitals. They can spotlight areas for additional questions — for example, asking about infection-control protocols, readmission-reduction programs, or wait times in the emergency department.
Practical steps patients can take when using the ratings:
- Check which specific measures contributed to a hospital’s overall score, rather than focusing only on the star count.
- Discuss any concerns with your primary care provider or with the hospital’s patient relations office.
- Consider recent local reviews and community reputation — state and regional improvements may not yet be reflected in federal data.
Context and limitations
CMS warnings and health-system leaders alike note limitations in the ratings. Some hospitals said portions of the data used in the 2026 ratings cover periods prior to recent investments or staffing changes designed to strengthen quality and safety. That lag can mean a hospital’s current performance is not fully captured.
Rave’s perspective underscores that the ratings are one tool among many: regulators, insurers and hospital systems use a mix of metrics — including more current internal measures — to monitor quality and patient outcomes.
Looking ahead
Hospitals that received lower star ratings will likely face scrutiny from state policymakers and payers, and may accelerate quality-improvement programs to address specific measures. Those with 5-star ratings may use the recognition to highlight strengths in patient experience and clinical outcomes.
For South Dakotans, the report is a reminder that hospital quality can vary widely and that informed conversations between patients and providers remain essential. As federal and state agencies continue to refine measurement methods, hospital leaders say they will press on with efforts to improve care in ways that matter most to their communities.
Camila Restrepo is the South Dakota correspondent for NEXO RADAR.
