Assisted Living in South Dakota

South Dakota ranks among the least expensive areas in the U.S. for assisted living care, which helped the state take 8th place overall in our 2022 Senior Living Report. The state’s population is growing at a healthy rate, even as others in the region decline, with close to 900,000 residents in total and 154,000 seniors as of the 2021 Census estimates. People of all ages have relatively good access to clean air and drinking water and a health care system that put South Dakota in 1st place in our report for patient satisfaction. Seniors, in particular, may benefit most from the significantly lower risk of respiratory illness and cancer from air pollutants.

The average cost for care in a South Dakota assisted living facility is $3,350 per month, according to the Genworth Financial 2020 Cost of Care Survey. Seniors who are still living in their own homes also save quite a lot on most other important costs of living, such as the savings of 28.8% on transportation and 16.2% on housing.

This guide is intended to help compare South Dakota’s assisted living costs with other areas. Medicaid and other possible sources of assistance are also explained. It also notes some local nonprofits and other government-supported organizations that help seniors. The guide has important information about the laws and regulations about South Dakota’s Assisted Living facilities.

The Cost of Assisted Living in South Dakota

As reported in the Genworth Financial 2020 Cost of Care Survey, assisted living facilities in South Dakota are priced at $3,350 per month. The U.S. average is 34% higher, at $4,500 per month, and all nearby states are more expensive than South Dakota for assisted living care. Minnesota and Montana are the least affordable, at $4,508 and $4,450 per month, respectively. Residents of Nebraska and Wyoming pay roughly $700-$800 more per month compared to those in South Dakota. The cost in North Dakota is virtually even, with the survey showing only $41 per month separating the Dakotas.

There was insufficient cost data for most cities in the state due to the relatively small populations. South Dakota’s most populous city, Sioux Falls, offers an average saving of $440 per month compared to the state overall. The monthly cost in Rapid City is significantly higher, with an average increase of $564. Even so, both surveyed cities in South Dakota are relatively affordable when comparing assisted living in the closest out-of-state cities. Assisted living costs in Cheyenne, WY, are more than $1,600 per month higher than Rapid City’s average, while Omaha, NE, has an average that’s $738 higher. Bismarck, ND, and Sioux City, IA, have monthly costs of $3,710 and $4,148, respectively.

Assisted living in South Dakota compares favorably to the other main types of care for seniors in terms of cost alone, at $3,350 per month. The average cost for home care and home health services is higher by more than $2,500 per month. With a monthly average cost of $2,600, adult day health care is a relatively affordable option for seniors who don’t require full-time care in their own home or facility. Nursing home care has an average cost of $7,118 per month in South Dakota, which is more than twice as expensive as assisted living facilities.

Does Medicaid Cover Assisted Living in South Dakota?

Yes, but only for South Dakota Medicaid recipients who qualify for a waiver program. The relevant program for seniors and people with disabilities is the HOPE Waiver, which is described in more detail below. Medicaid and its waiver programs are intended to help low-income residents with limited assets and, as such, the recipient may be required to spend a certain amount of their monthly income on care services before Medicaid coverage takes over.

In any case, coverage for assisted living and some other home and community-based services via Medicaid isn’t guaranteed, even for those eligible for the HOPE Waiver program. There may be a waiting list at times, for example, or the requested services may be deemed unnecessary or inappropriate for the individual.

What Assisted Living Services Are Covered by Medicaid in South Dakota

Medicaid and the HOPE Waiver provide coverage for a long list of personal care and other services, which includes many assisted living facility services in particular. The South Dakota DHS website has a detailed list of the covered services and we’ve made a brief summary of the relevant points below for assisted living residents. Ultimately, the amount and type of services covered are determined for each person based on their specific needs.

• Homemaker and chore services
• Personal care
• Meals and meal preparation
• Emergency response systems
• Environmental accessibility adaptations
• Supervision and security
• Recreational programming and activities
• Social programming
• Community transition (moving from nursing home to assisted living)
• Specialized medical equipment and supplies
• Nutritional supplements

Room and board costs are never covered by South Dakota Medicaid or its waiver programs. The state limits the amount that assisted living facilities can charge for room and board, however, which is $693 per month as of 2022. This limit only applies to HOPE Waiver recipients in assisted living facilities that accept Medicaid.

Assisted Living Waiver Programs in South Dakota

HOPE Waiver

South Dakota helps eligible Medicaid recipients via waivers, which extend coverage to services that aren’t otherwise covered, such as care in assisted living facilities. The HOPE Waiver program is available to South Dakota seniors and people with disabilities who are assessed as in need of the relevant services in order to avoid being placed in a nursing home. If the individual’s care needs can be provided for in a less restrictive living environment — and one that’s less expensive — then the HOPE Waiver covers the cost of care.

How to Know if You’re Eligible for Medicaid in South Dakota

South Dakota Medicaid is designed to help people who can’t afford to pay for their required care. There are limits on the number of countable assets owned by the applicant and or a couple, as well as the maximum income allowed. These financial eligibility requirements are based on the SSI federal benefit rate, which changes each year. An individual must have income no higher than 300% of the monthly SSI payment. The income and asset limits for 2022 are listed below.

Aside from the financial eligibility rules, applicants must meet the following requirements. Seniors who aren’t sure whether they’re eligible should ask for assistance from the agencies listed further below in this guide.

• Be aged 65+ (or blind or disabled)
• Must be a resident of South Dakota and planning to stay
• Be a U.S. citizen or legally admitted with valid immigration status
• Must have been assessed as having medical needs that meet a nursing home level of care
• Not currently residing in a hospital, nursing home or intermediate care facility

It’s important to note that the requirement for a nursing home level of care doesn’t necessarily exclude seniors in assisted living facilities. If it’s determined that the applicant could receive that level of care in an assisted living facility, they may qualify for Medicaid coverage of the services received there.

How to Apply for Medicaid in South Dakota

Applications can be submitted by mail or in person at DSS offices throughout South Dakota. Although it’s possible to apply for other Medicaid benefits online, the form for Medicaid assistance for long-term care must be printed and taken or mailed to the Department of Social Services.

Information You Will Need

Due to the income and asset limits mentioned above, applicants for Medicaid long-term care assistance should prepare as much information as possible regarding their financial situation. The following is a general list of requirements to keep in mind.

• Social Security number
• Valid identification and proof of age
• Immigration/citizenship documentation (if not a U.S. citizen)
• Proof of South Dakota residency
• Financial details (income, assets owned, life insurance policies, household expenses, etc.)

The financial details should include 90 days of the applicant’s most recent bank statements and bills showing the cost of large household expenses. Proof of state residency can be as simple as showing a utility bill for a South Dakota address.

How to Get Help Applying for Medicaid

South Dakota seniors and anyone acting on their behalf can contact the programs detailed below to get answers to questions and help with the application process. These services are provided at no cost.

Does Medicare Cover Assisted Living in South Dakota?

The short answer is that no, Medicare does not cover the cost of assisted living in South Dakota. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in South Dakota.

Other Financial Assistance Options for Assisted Living in South Dakota

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

Free and Low-Cost Resources for Seniors in South Dakota

There are many helpful resources and services available for the elderly and people with disabilities in South Dakota. The following agencies and organizations provide free and low-cost services ranging from individualized counseling to determine long-term care options, in-home care and meal delivery, assistive technology and help qualifying for assisted living coverage.

COVID-19 Rules for Assisted Living in South Dakota

The following information is based on research done on several government websites, including cdc.gov and doh.sd.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/25/22, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Outings & Social Activities

COVID-19 Safety Measures for Staff and Residents

Assisted Living Laws and Regulations in South Dakota

The South Dakota Department of Health and specifically the Office of Health Facilities Licensure and Certification are tasked with licensing and inspecting assisted living and other health care facilities. The applicable state regulations must be followed by all facilities, and those that accept Medicaid and/or Medicare must also meet federal standards.

Frequently Asked Questions