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Memory Care in South Dakota

Of the almost 900,000 people who call South Dakota home, more than 17% are aged 65 and older. With this large senior population, memory-related conditions are a growing concern in South Dakota. It’s estimated that the number of older adults with Alzheimer’s disease will increase by 11.1% between 2020 and 2025 to 20,000 people. It’s also the fifth leading cause of death in the state, with 495 deaths attributed to the condition in 2019.

South Dakota offers a number of benefits for people living with Alzheimer’s and other forms of dementia. The cost of memory care in the state is low, averaging just $4,188 per month. Affordable care, coupled with a low cost of living and a retirement-friendly tax system, means that retirement savings will last longer in South Dakota. Quality hospitals can provide care when needed and there are specialty centers, such as Sanford Neurology Clinic, for those with Alzheimer’s disease.

Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.

This guide has  information about the cost of memory care in South Dakota, along with the cost of other senior living options in the state. It also contains an overview of financial assistance available, rules and regulations governing memory care and resources that can help you as you age.

The Cost of Memory Care in South Dakota

Note: People who require memory care in the United States typically receive it as an added service in an assisted living facility, which means that memory care cost data isn’t tracked. Usually, memory care services cost 20%-30% more than standard assisted living rates. To calculate the estimates used below, we added 25% to the assisted living costs in the Genworth 2021 Cost of Care Survey.

Memory care in South Dakota costs an average of $4,188 per month. This is $1,437 lower than the national average of $5,625. South Dakota is also affordable when compared to its neighbors. North Dakota has similar costs at $4,239 per month, while Nebraska and Wyoming are midrange for the area at $5,095 and $5,211, respectively. In Montana, the monthly average is $5,563, while Minnesota has the highest costs in the region at $5,635. 

Memory care costs in South Dakota can vary depending on where you live. Sioux Falls is the most affordable city at $3,638 per month. Rapid City’s average is higher than the statewide median at $4,893. Cities in neighboring states also have a wide range of prices. Grand Island, Nebraska, and Mankato, Minnesota, are close to the Sioux Falls rate at $3,633 and $3,919, respectively. At $4,638 per month, Bismarck, North Dakota, has an average cost just below Rapid City’s. Care in Casper, Wyoming, is significantly higher at $6,055 per month.

Rapid City


Sioux Falls


Grand Island, NE


Mankato, MN


Bismarck, ND


Casper, WY


Memory care isn’t the only senior living option available in South Dakota. Adult day health care is the most affordable choice at $2,600 per month, while assisted living averages $3,350. Home care and home health care in the state both cost $5,911 per month. The most expensive option is nursing home care at $7,118 for a semiprivate room and $7,604 for a private room.

Adult Day Health Care


Assisted Living


Home Care


Home Health Care


Memory Care


Nursing Home Facility (semiprivate room)


Nursing Home Facility (semiprivate room)


Does Medicaid Cover Memory Care in South Dakota?

Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in South Dakota.


In South Dakota, Medicaid doesn’t cover memory care directly. However, it offers a waiver program that can be used to provide memory care in assisted living environments. This is known as the HOPE Waiver, which stands for Home and Community-Based Options and Person Centered Excellence Waiver.

The HOPE Waiver is designed to help people stay living at home or in the community and covers a range of services to achieve this goal. The primary benefit provided is assistance with activities of daily living, however recipients can also receive homemaker support, delivered meals and home modifications. Not all benefits are available in all living settings.

What Memory Care Services Are Covered by Medicaid in South Dakota?

In South Dakota, the waiver program pays for memory care and other services provided in an assisted living setting. The exact services a recipient can access is based on their personalized care plan and are bundled into the assisted living category. For example, a recipient residing in a memory care community can’t receive separate homemaker, personal care or chore services because these are all covered under assisted living. 

Memory Care Waiver Programs in South Dakota

Home and Community-Based Options and Person Centered Excellence Waiver

The HOPE Waiver was previously known as the HCBS Waiver or Elderly Waiver. It’s designed to help people stay living in the community even if they need a nursing home level of care. In addition to requiring a high level of care, applicants must be aged 65 or older, or aged 18 or over and have a qualifying disability. Participants must also meet the program’s financial eligibility criteria. 

All applicants must complete a needs assessment to determine the care they require through the program. Recipients must also receive one or more waiver services at least once per month. 

The program has a wide range of services available for eligible seniors, including personal care, meal preparation, chore services, social and recreational programming and medication assistance. The waiver doesn’t cover 24-hour skilled care, room and board or items of comfort or convenience. In general, the amount covered is no greater than the average cost of nursing home care, but there’s an exceptions process that may provide additional funds. 

The HOPE Waiver program has an enrollment cap. Applicants may be able to go on a waiting list, but this isn’t always the case in South Dakota. For more information, or to apply for the program, contact your local Department of Social Services office or the Dakota at Home resource center at (833) 663-9673.

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

Medicaid eligibility in South Dakota is based on a number of factors, including your age, income, assets and disability status. The exact eligibility requirements differ depending on your circumstances, but those applying for the HOPE Waiver must be:


  • A South Dakota resident
  • A U.S. national, citizen, permanent resident or legal alien
  • Aged 65 and older, or aged 18 and older with a qualifying disability
  • Assessed as needing a nursing home level of care
  • Under the income limit of $18,075 per year for singles, or $24,353 for married couples who are both applying
  • Under the asset limit of $2,000 for singles, or $3,000 for married couples who are both applying

2022 Medicaid Income Limits for Seniors in South Dakota

NameAnnual income limitsAsset limits
Single Applicant$18,075$2,000
Two-Person Household (Only One Person Applying)$24,353$2,000 applicant $137,400 non-applicant 
Two-Person Household
(Both People Applying)

Not all assets are counted when calculating Medicaid eligibility. Personal belongings, an automobile and certain burial trusts aren’t included. In addition, a person’s primary home isn’t counted if they intend to return, or if their spouse still lives there. When only one spouse applies for Medicaid, the non-applicant spouse may also be eligible for the Minimum Monthly Maintenance Needs Allowance. This allows them to keep part of the applicant’s income to ensure they can meet their needs. 

How to Apply for Medicaid in South Dakota

You can apply for Medicaid in South Dakota by submitting a completed application by mail, fax or in person to a local Department of Social Services office. Application forms can be downloaded from the website or requested from a local office. Currently, there’s no online application process for long-term care programs.

Information You Will Need 

The Department of Social Services requires documentation to assess your application. The exact type differs based on your circumstances, but you generally need proof of:


  • Identity and date of birth
  • Citizenship
  • Income
  • Assets, such as insurance, burial accounts or trusts
  • Housing costs
  • Existing health insurance, such as a Medicare card

How to Get Help Applying for Medicaid

Local offices of the Department of Social Services are the primary source of assistance for people applying for Medicaid in South Dakota. The department also has a website that can answer common questions and the state-run Senior Health Information and Insurance Education may also be able to provide assistance.

ProgramContactServices provided
Department of Social Services local offices(605) 773-4678Local offices of the Department of Social Services handle Medicaid applications and are able to answer questions about the process. Team members can also help you complete an application. Although interviews aren’t required to apply for Medicaid in South Dakota, you can request one through your local office if you feel it will make the application process easier.
Department of Social Services websiteOnlineThe Department of Social Services’ Medicaid website has detailed information about the program and how to apply. This includes frequently asked questions that can help you determine your eligibility and understand your benefits and responsibilities.
Senior Health Information and Insurance EducationLocal phone numbers available onlineSHIINE provides counseling and education about health insurance to people over age 65 in South Dakota. Although the program is designed to help people navigate the Medicare program, counselors may be able to provide assistance with other health insurance programs, such as Medicaid.

Does Medicare Cover Memory Care in South Dakota?

The short answer is that no, Medicare does not cover the cost of memory care in South Dakota. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will 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 Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in South Dakota.

Other Financial Assistance Options for Memory Care 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 Memory Care affordable.

NameHow To ApplyHow It Works
Aid and AttendanceLearn more and apply online at who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.
Reverse MortgagesLearn more about your options and how to apply at ftc.govIf you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in South Dakota

Seniors who require memory care and their families can find a number of free and low-cost resources in the state that provide advocacy, respite care and other support. These services are offered by government agencies as well as nonprofit organizations. 

Division of Long Term Services and SupportContact local officesAs part of the Department of Social Services, the Division of Long Term Services and Support’s mission is to promote long term care services and help people stay living in the community. Support specialists located in the field offices provide a range of services, including care planning, case management and referral services.
Dakota at Home(833) 663-9673Dakota at Home is South Dakota’s Aging and Disability Resource Center. It has a helpline and an online resource directory where you can find local support services. In addition, you can access options planning, which can help you make decisions about memory care.
Long Term Care Ombudsman Program(866) 854-5465The Long Term Care Ombudsman program was created to protect the rights of people living in nursing homes and assisted living communities, including those that provide memory care. Local ombudsmen receive, investigate and help resolve complaints. In addition, they raise awareness of elder rights by educating both the community and staff in long-term care facilities.
Alzheimer’s Association - South Dakota Chapter(800) 272-3900The Alzheimer’s Association is a nationwide nonprofit organization that provides information and support to people with Alzheimer’s disease and other memory-related conditions. It operates a 24-hour helpline with trained staff who can answer questions and provide referrals to local resources. The South Dakota chapter has support groups in a number of cities around the state and offers care consultations to help people plan their future.
Music & Memory South Dakota(605) 336-3505A project of the South Dakota Foundation for Medical Care, the Music & Memory program helps people with cognitive and physical conditions engage with the world through music. This evidence-based therapy has been shown to decrease agitation and anxiety and improve well-being. Through this project, the foundation trains staff and family caregivers on how to implement the program.

Memory Care Laws and Regulations in South Dakota

In South Dakota, memory support services are generally provided in assisted living centers in memory care units. The South Dakota Department of Health regulates assisted living centers and enforces various laws regarding aspects such as scope of care, staff hiring and training, medication management and care planning.

Scope of CareMemory care facilities provide assistance with daily living activities, medication management, infection control, as well as housing, three daily meals and housekeeping and laundry services. They must also provide specialized programming and secured indoor and outdoor areas to meet the needs of those with dementia.
Care PlansMemory care facilities are required to create personalized written care plans for residents to ensure safe and effective care from the day of admission. Care plans must be provided upon admission, 30 days after admission and at least annually and should address personal care, as well as the resident’s medical, dietary, emotional, physical and cognitive needs.
Medication ManagementA pharmacist must review the drug regimens of all memory care residents who are on prescription medications. Medications must be stored in a locked storage area in their original containers. Medications can be administered by registered nurses or unlicensed personnel who have completed resident-specific medication administration training. Residents who have the cognitive ability to self-administer medications, including insulin injections, may do so, and they may store medications in their rooms. A physician, physician’s assistance or nurse practitioner must evaluate their ability to self-administer medications as least quarterly.
StaffingSouth Dakota doesn’t have minimum staffing ratios, but facilities must have enough qualified staff members to provide safe and effective care at all times. Facilities are prohibited from hiring individuals who have been convicted of abusing another person. All staff members must complete a formal orientation program within 30 days of their hire date and an ongoing education program annually. Topics that the training should cover include nutritional and hydration needs of residents, accident prevention, infection control, problem solving techniques for residents with cognitive impairments and resident rights. Any staff members who work in memory care units must have specific training regarding the unique needs of residents in that unit. At least one caregiver must be on duty at all times. The facility must have a plan for increasing staffing during times of resident illnesses.
Medicaid CoverageMedicaid covers memory care through the HOPE waiver, which is a Home and Community Based Services program. Applicants are subject to the waiver’s income, asset and residency guidelines.
Reporting AbuseMemory care facilities are required to have a grievance process that enabled residents to file complaints verbally or in writing regarding care or lack of care, the behavior of other residents and infringement of the resident’s right. Complaints may also be filed with the state’s Long Term Care Ombudsman office by calling 866-854-5465.

Frequently Asked Questions

Directory of Memory Care Facilities in South Dakota

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Memory Care in South Dakota

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The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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