Five Counties Nursing Home: Arbitration Agreement Failures - SD
The agreement didn't name the arbitration organization. It didn't say how to contact that organization. It didn't provide for the selection of a neutral arbitrator agreed upon by both parties. It didn't address where a dispute would actually be heard, or whether that location would be convenient for the people involved.
The administrator, identified in the inspection report as Administrator A, agreed with all of it.
Then, the following day, she confirmed something else. Five Counties had no policy on arbitration agreements at all. She told inspectors the agreement was "poorly written."
Arbitration agreements in nursing home admissions paperwork carry real weight. When residents or their families sign them, they are waiving their right to take disputes to court. They are agreeing instead to resolve complaints, including complaints about care, through a private arbitration process. The specifics of that process, who runs it, who picks the arbitrator, where it happens, are not incidental details. They are the substance of what a resident is giving up their right to contest.
The agreement at Five Counties, a one-page document, left all of those specifics out.
Inspectors reviewed the agreement and conducted their first interview with Administrator A on the evening of March 10, 2025, at 5:43 p.m. She confirmed the omissions. The next afternoon, at 1:10 p.m. on March 11, she confirmed there was no policy behind the agreement either.
The deficiency was cited as affecting many residents and was classified at the level of minimal harm or potential for actual harm. The inspection was completed March 12, 2025.
What that classification doesn't capture is the position it put residents in. An arbitration agreement that doesn't name the arbitration organization, doesn't provide a way to contact it, doesn't specify how an arbitrator gets selected, and doesn't address where proceedings would take place isn't really an agreement in any functional sense. It's a document that asks residents to sign away dispute rights in exchange for a process that hasn't been defined.
The administrator didn't dispute that. She called it poorly written and acknowledged the facility had no framework behind it.
Five Counties Nursing Home sits on 6th Avenue West in Lemmon, a small city in the northwest corner of South Dakota, near the North Dakota border. Like many rural nursing homes, it serves a population with limited alternatives. Residents who sign admission paperwork there, as at any nursing home, are often doing so during a stressful transition, without lawyers present, without time to scrutinize the fine print of a one-page arbitration clause.
That one-page document, inspectors found, didn't give them the information they would have needed to understand what they were agreeing to, even if they had scrutinized it.
The administrator agreed the agreement was poorly written. She agreed it was missing the arbitration organization's name. She agreed it was missing contact information. She agreed it didn't address how a neutral arbitrator would be selected. She agreed it didn't address location. She confirmed there was no policy.
What she didn't say, and what the inspection report doesn't say, is how long the agreement had been in use, or how many residents had signed it.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Five Counties Nursing Home from 2025-03-12 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Last verified: November 11, 2026 · Our methodology
Five Counties Nursing Home in LEMMON, SD was cited for violations during a health inspection on March 12, 2025.
The agreement didn't name the arbitration organization.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.