Two facilities within the Avera Health system had the highest CMS ratings in South Dakota, with 5-star ratings given to Avera Heart Hospital of Sioux Falls and Avera St. Luke's Hospital in Aberdeen. The lowest ratings in South Dakota were also in the Avera system, where 3-star ratings were given to Avera McKennan Hospital & University Health Center in Sioux Falls and Avera St. Mary's Hospital in Pierre. Get South Dakota stories Get the latest articles from South Dakota News Watch straight to your inbox. Monument Health Rapid City Hospital, shown on April 17, 2024, in Rapid City, S.D., has improved its quality ratings. In recent years, the CMS quality ratings have shown a general decline across the U.S.