Five Counties Nursing Home: Video Monitoring Violations - SD
Federal inspectors who visited Five Counties Nursing Home on March 12 found the facility had failed on both counts. Some residents had signed consent forms. Others had not. And the signs that the facility's own policy required to be posted, the ones that were supposed to read THIS ROOM CONTAINS A VIDEO MONITORING DEVICE, were not where they needed to be.
The violation was cited at the minimal harm level, meaning inspectors did not find evidence that residents had suffered direct injury as a result. But the finding cuts at something that nursing home residents have precious little of: the knowledge of who is watching them, and when, and whether anyone thought to ask.
Five Counties is a 50-bed facility serving Lemmon and the surrounding communities of Perkins, Corson, Dewey, Ziebach, and Campbell counties, one of the most sparsely populated stretches of the northern Great Plains. For many residents, it is the only long-term care option within a reasonable distance of their families and their homes. The choice to place a camera in someone's room is not a trivial one in that context. It is a decision made in a space where a person sleeps, bathes, receives medical care, and spends the hours of their remaining years.
The facility's own written policy laid out what was required. Staff were to obtain a signature from residents indicating either consent or refusal of video monitoring. The last page of that policy specified that a sign was to be posted in any monitored room. Inspectors reviewed the policy and found the gap between what it said and what the facility had actually done.
Some residents had signed the form. The inspection report does not specify how many had not. It says only that some residents were affected, which under CMS inspection terminology means more than one but fewer than all.
The residents who had not signed had not been given the formal choice the facility's own procedures promised them. The residents in monitored rooms had not been told by any posted notice that a device was recording their space. Whether they knew through other means, whether staff had mentioned it in conversation, whether family members had arranged the monitoring and assumed that was sufficient, the inspection report does not say.
Video monitoring in nursing homes sits in complicated territory. Families sometimes request cameras to watch for abuse or neglect. Residents sometimes want them for their own sense of security. Facilities sometimes install them for operational reasons. The technology can protect vulnerable people. It can also be used against them, or simply imposed on them without the courtesy of an explanation.
South Dakota law and federal guidance both treat resident consent as the threshold requirement before monitoring begins. The form Five Counties used acknowledged this. It gave residents a line to sign for consent and a line to sign for refusal. That structure only works if someone actually presents it to the resident and waits for an answer.
For the residents at Five Counties whose signatures were never collected, that conversation never happened. They may have been monitored. They may not have been. What the record shows is that nobody confirmed their wishes either way, and that no sign on the wall told them what was happening in their own room.
The facility was given the opportunity to submit a plan of correction. That plan was not included in the publicly available inspection materials. Anyone seeking information about what Five Counties intends to do differently can contact the facility directly or reach the South Dakota Department of Health.
What the inspection left unresolved is simpler than any regulatory response: somewhere in that building, a person lived in a room, and nobody thought it was necessary to tell them whether they were being watched.
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.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: November 7, 2026 · Our methodology
Five Counties Nursing Home in LEMMON, SD was cited for violations during a health inspection on March 12, 2025.
Federal inspectors who visited Five Counties Nursing Home on March 12 found the facility had failed on both counts.
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.